A comparison of botulinum toxin a and intralesional steroids for the treatment of plantar fasciitis: a randomized, double-blinded study

Foot Ankle Int. 2013 Jan;34(1):8-14. doi: 10.1177/1071100712460215.


Background: The objective of this study was to compare intramuscularly applied botulinum toxin A (BTX-A) in the gastroc-soleus complex with intralesional steroids for the treatment of plantar fasciitis.

Methods: The patients were randomly divided into 2 groups according to the treatment received. The patients were evaluated over 6 months. The evaluation scores included the Visual Analog Scale (VAS), Maryland Foot and Ankle, Foot and Ankle Disability Index (FADI), and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, patients were instructed to perform plantar fascia stretching exercises over the course of the study. The final number of patients was 36, of whom 19 received BTX-A (10 men and 9 women) and 17 (6 men and 11 women) received steroids.

Results: When compared to patients who received steroids, the patients who received BTX-A exhibited more rapid and sustained improvement over the duration of the study.

Conclusion: A combination of BTX-A and plantar fascia stretching exercises yielded better results for the treatment of plantar fasciitis than intralesional steroids.

Level of evidence: Level I, therapeutic studies.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analysis of Variance
  • Botulinum Toxins, Type A / therapeutic use*
  • Dexamethasone Isonicotinate / therapeutic use*
  • Disability Evaluation
  • Double-Blind Method
  • Fasciitis, Plantar / therapy*
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Injections, Intralesional
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Muscle Stretching Exercises
  • Neuromuscular Agents / therapeutic use*
  • Prospective Studies


  • Glucocorticoids
  • Neuromuscular Agents
  • Dexamethasone Isonicotinate
  • Botulinum Toxins, Type A