103 Botulinum Toxin Type A (Botox) Injection for Plantar Fasciitis: An Audit of Findings

Introduction

Plantar fasciitis is commonly seen in the musculoskeletal clinic and accounts for around 8-10% of running injuries. NICE recommended corticosteroid injections for patients whose “symptoms are having a significant impact on the person”, however, symptoms lasted for 4 weeks post injection. The use of Botox for the treatment of myofascial pain has increased, with studies showing greater reduction in patients symptoms and improved duration of action.

Material and methods

42 patients (27 male, 15 female) were included in this audit. All patients received 100 units of botox.

Inclusion/Exclusion criteria

All patients who had clinically diagnosed plantar fasciitis and had received the first line treatments of stretching and orthotics.

Patients yet to begin a stretching program or had systemic disease or previous surgery were excluded.

Outcome measure

A patient assessed (VAS) and a physician assessed (Heel Tenderness Index) outcome measure was used.

Results

42 patients were assessed.

VAS

All the patients reported an improvement in symptoms at the 4 week follow up, 38 (90.48%) of whom reported pain free. Of the remaining 4 all advised their symptoms had improved by at least 50%

HTI

38 (90.48%) had no pain on palpation of the heel post injection, whilst prior to the injection all patients had pain in differing degrees. 15 patients (35.71%) had severe pain prior to the injection, post injection no patient had severe pain. 40 (95.24%) patients had improved HTI scores.

Conclusions

Botox is effective in the treatment of plantar fasciitis, however, its effectiveness in the longer term needs to be assessed.