Botulinum Toxin A Versus Steroids for the Treatment of Chronic Plantar Fasciitis: a Randomized Controlled Study

What this Trial Is About

Plantar fasciitis is a common cause of heel pain that leads to significant healthcare costs and work disability, especially in Switzerland. Despite various treatments, no single approach has proven clearly superior, and there is no consensus on the best nonoperative therapy. Researchers are studying whether injecting botulinum toxin A (BTX-A) into the calf muscles can offer better treatment by targeting the muscle tightness that contributes to the condition. In this randomized study, participants are assigned to one of three groups. One group receives BTX-A injections into the gastrocnemius and soleus muscles along with physiotherapy and stretching exercises. The second group gets cortisone injections at the plantar fascia insertion site combined with the same physiotherapy. The third group receives saline injections as a placebo control, also combined with physiotherapy and stretching. Each BTX-A injection involves 100 units into each gastrocnemius muscle belly and 50 units into the soleus, totaling 250 units. Participants will be followed over time to assess changes in foot pain, health, disability, activity restriction, ankle motion, and inflammation. These evaluations occur at 6 weeks, 3 months, 6 months, 12 months, and 24 months. MRI scans will assess inflammation before treatment and at 12 months. The study aims to provide clear evidence comparing BTX-A, cortisone, and placebo injections to help guide future treatment choices. The total duration of participation may last up to two years with regular assessments.

Botulinum Toxin A Versus Steroids for the Treatment of Chronic Plantar Fasciitis