Therapeutic Effect of Botulinum Toxin A for the Treatment of Plantar Fasciitis.
Status:
Completed
Trial end date:
2020-04-01
Target enrollment:
Participant gender:
Summary
Plantar fasciitis is the most common cause of plantar heel pain and is commonly present in
people 40 years of age or older, overweight, sedentary or with intense physical activity. It
is caused by the over-stretching of the plantar fascia, which is a band of connective tissue
that extends to the base of the phalanges. This produces micro-tears more commonly in its
origin in the medial tuberosity of the calcaneus which causes an inflammatory process and
pain. This pain usually occurs when the person gets up in the morning after sleeping or after
sitting for a long time. That is when the fascia is stretched after being in a contraction
position.
There are a great variety of treatments for this pathology, of these, one of the most common
is the use of intralesional steroids, which a weighing that reduces symptomatology in many
cases also has undesirable effects such as subcutaneous fat atrophy, rupture of the plantar
fascia, peripheral nerve injury, muscle damage and stress fractures. Other treatments are
extracorporeal shock waves, application of platelet-rich plasma and application of botulinum
toxin A intralesional. All of them are accompanied by insoles, night splints and stretching
exercises of the Achilles tendon and the plantar fascia.
Recent studies have shown that the application of botulinum toxin A intralesional in patients
with plantar fasciitis helps to improve the symptomatology to decrease pain in both intensity
and presentation time. Decreased inflammation of the plantar fascia has also been
demonstrated. This is the sale of the usual form of action of the botulinum toxin, which is
applied regularly in the muscles to block the release of acetylcholine in the neuromuscular
plaque and obtain its relaxation and not directly in the pain points. We believe that the
botulinum toxin can be applied intralesional currently, since there is information that the
toxin has analgesic and anti-inflammatory effect and not just muscle relaxation.
The aim of our work demonstrate that the use of botulinum toxin A and intralesional
stretching exercises is superior to intralesional steroids and stretching trying to establish
a safer and less painful therapy avoiding complications prior to the application of steroid
application.