Article

Plantar fasciitis is a common cause of heel pain and is the result of a
degenerative process of the plantar fascia at its calcaneal attachment. A case
study of a preliminary experience with local injections of botulinum toxin A
(BTX-A) for the treatment of chronic plantar fasciitis in a 43-year-old woman is
presented. We injected the patient with 70 units of BTX-A (0.7mL) in 2 divided
doses: 40 units (0.4mL) in the tender region of the heel, and 30 units (0.3mL) in
the most tender point of the foot arch. Visual analog scale (VAS) and pressure
pain threshold (PPT) were measured to evaluate the efficacy of BTX-A injections.
Real-time, high-resolution ultrasonographic findings of the plantar fascia after
BTX-A injections were also used for serial follow-ups. After BTX-A injection,
decreased VAS values were reported and increased PPT was observed. In
ultrasonographic studies, the thickness of the plantar fascia and the
hypoechogenicity of the fascia were reduced. Decreased plantar fascia thickness
was observed on the first and third week after BTX-A injections. The findings
were compatible with the changes in pain assessed by VAS and PPT.
Ultrasonographic findings also indicated a progressive decrease in the thickness
of the underlying muscle belly. Ultrasonography seems to be a valuable,
noninvasive diagnostic tool for the evaluation of plantar fasciitis treated with
BTX-A injections. It can offer objective measurements of therapeutic effects and
is feasible for serial follow-ups.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS