[Treatment of chronic plantar fasciitis with botulinum toxin A--an open pilot study on 25 patients with a 14-week-follow-up].
OBJECTIVE
The conservative and operative treatments of plantar fasciitis tend to be tedious. Unsatisfactory results are common in chronic cases. This study was performed in order to test the hypothesis that the analgesic and anti-inflammatory effect of a single injection of Botulinum toxin A (BoNT A) induces a significant reduction of symptoms.


METHODS
25 patients were included and followed-up for 14 weeks. Prior to injection, all of them had undergone at least two trials of conservative treatment. To determine the optimal treatment dose, 6 patients were injected subfascially with 100 units BoNT A (Dysport), another 6 with 200 units BoNT A. As result of this pre-trial, another 13 patients were treated with the higher dose. The patients documented maximum pain and continuous pain on a visual analogue scale. The strength of the lower leg and foot muscles was clinically assessed.


RESULTS
A significant reduction of maximum and continuous pain was seen 2 weeks after injection in the group of 19 patients treated with 200 units BoNT A and persisted until the end of the follow-up. Adverse effects such as weakness of the muscles or systemic reactions have not been observed.


CONCLUSIONS
This pilot study shows the efficacy of a single application of 200 units BoNT A as a treatment option for chronic plantar fasciitis.
Placzek
R
R
Centrum für Muskuloskeletale Chirurgie, Charité--Universitätsmedizin Berlin, CVK, Augustenburger Platz 1, 13353 Berlin. richard.placzek@charite.de
Hölscher
A
A
Deuretzbacher
G
G
Meiss
L
L
Perka
C
C
D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D036981:Fasciitis, Plantar / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome
D019274:Botulinum Toxins, Type A