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| |  Botulinum Toxin Injections Appear to Provide Long-Term Pain Relief for Patients With Chronic Plantar Fasciitis: Presented at AAPM By Ed Susman KISSIMMEE, FL -- February 20, 2008 -- Researchers suggest that botulinum toxin can be used to relieve pain and improve walking function of the ankle, knee, and hip for patients suffering from painful chronic plantar fasciitis. While previous trials using botulinum toxin to relieve pain due to plantar fasciitis have shown efficacy, the studies used different techniques, injecting the agent in the plantar surface of the foot or into the heel and calf muscles. "We think that by treating the medial and lateral gastrocnaemius and the soleus muscles, we can cause those muscles to relax and therefore possibly treat the cause of plantar fasciitis as well," said Mohsin Sheikh, MD, Fellow in Pain Medicine, University of North Carolina, Chapel Hill, North Carolina, United States. Dr. Sheikh presented his findings in a poster presentation on February 15 here at the American Academy of Pain Medicine (AAPM) 24th Annual Meeting. In the pilot study involving 10 patients with refractory plantar fasciitis, Dr. Sheikh and colleagues randomised 5 patients to two study groups in a double-blind fashion: the first group received 50 units of botulinum toxin type A in the heel plus 50 units in the motor site of the soleus, and 25 units at both the medial and lateral gastrocnaemius motor points; the second group received injections with 50 mg botulinum toxin type A in the heel, and saline in the other positions. After 12 weeks, the group given all four injections with active treatment demonstrated a decline of 5.3 points on a 10-point visual analogue scale, while the group given the standard treatment showed a decline in pain of about 2 points. Despite the small number of patients in the study, the difference was statistically significant (P = .0367), Dr. Sheikh said. On a 100-point visual analogue scale, function increased by 21 points in the group injected in 4 points and increased by 14.2 points in the group injected with traditional treatment. Ankle range of motion and knee range were significantly improved in the group injected in 4 points compared with the traditional treatment. Overall, the improvement in function trended towards significance, Dr. Sheikh said. The researchers are planning to expand the trial to include more patients. The study drug was provided by Allergan, Inc.
[Presentation title: Preliminary Results of a Novel Method for the Treatment of Chronic Plantar Fasciitis With Botulinum Toxin Type-A: A Randomized, Double-Blind and Biomechanical Study. Abstract 196]
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