A new study out of Mexico found that Botox injections helped treat foot aliments like plantar fasciitis better than common steroids.
Plantar fasciitis occurs when the connective tissues on the bottom of the feet become inflamed. The injury is common for people that put a lot of stress on their feet, like runners or overweight individuals. Common steroids are sometimes used to address plantar fasciitis, but about two to six percent of steroid treatments can lead to a rupture of the plantar fascia.
Researchers at the Autonomous University of Nuevo Leon wanted to find an alternative treatment option for patients suffering from plantar fasciitis. They decided to see how botulinium toxin, commonly known as Botox, affected patients.
Botox works by blocking a neurotransmitter called acetylcholine, which leads to a weakened muscle state for several months. They believed the Botox injections would lead to less foot pain in patients and result in less fascia ruptures.
For their study, researchers divided 36 individuals into two double-blind groups. One group received the Botox injections, while the other group received the normal steroid injections. Both groups also participated in foot-stretching exercises, another common course of treatment.
Findings
During the recovery process, individuals who received the Botox injections reported less pain than those who received steroid injections. The people who underwent the Botox treatment also reported better foot function and alignment.
Conclusion
“We found that a combination of [Botox] applications into the gastroc-soleus complex and plantar fascia stretching exercises yielded better results for the treatment of plantar fasciitis than intralesional steroids,” said, Dr. Carlos Acosta-Olivo, who administered the study. Researchers hope to test their methods on a larger group to see if Botox can reduce the rate of fascia ruptures associated with common steroids.
Dr. Silverman comments:
Botox injections are very controversial, but I would be interested to see this study conducted with a larger sample size.
Cortisone injections cause plantar fascia tissue to degenerate and rupture (acutely or gradually). Regardless, the tissue can become incompetent. Some people tolerate this rupture as the foot has other supportive structures, but many don’t. I do not inject the plantar fascia on patients as I feel such treatment, while standard of care, violates the sense test (“If it doesn’t make sense, don’t do it”).
Cortisone denatures collagen and causes tissues under tension to rupture. Doctors do not perform cortisone injections into tissues that are tearing without expecting the tissue to tear anywhere else in the body except the plantar fascia. If they did they would be sued for malpractice. Injections of the Achilles and the patellar tendon were done in the past and many people sustained tendon ruptures.
So why does injection of the plantar fascia persist? Because rupture is only symptomatic in some and not in others, confounding the results. This is where the study is most flawed. They compare cortisone in the plantar fascia to essentially a temporary paralysis of one of the largest, most powerful muscles in the body. Botox to the gastrocneumius passes the sense test and the early results lend support to this deduction
Related source: Science Daily
