Botox, an unlikely candidate for treating a common running injury, shows promise. Although Botox is more commonly associated with a way for the Real Housewives of Anywhere to turn back the clock, it has been approved by the Food and Drug Administration for the treatment of a number of other, more serious medical conditions, such as limb spasticity following a stroke, overactive muscle disorders, excessive sweating, and chronic migraines. In order to alleviate the pain associated with plantar fasciitis, a common issue among runners, one of the world’s leading experts on Botox’s therapeutic uses has been administering injections of the drug for quite some time.

Just as Botox is injected beneath the skin to temporarily smooth out wrinkles, it can be injected into the inflamed ligament that runs underneath your foot to temporarily relieve pain and pressure (by paralyzing the muscles and allowing them to relax). One medical professional estimates that 150 patients have been cured of plantar fasciitis. This condition causes inflammation of the tissue that runs from the bottoms of the feet to the bottoms of the heels.

A Glimpse of Plantar Fasciitis

Plantar fasciitis is a foot condition that no one seems to understand. Athletes frequently suffer from plantar fasciitis (10% or so), making it one of the most prevalent running injuries. Inflammation of the plantar fascia, a ligament that runs from the heel to the toes, and the sensory nerves in its vicinity can result from increased mileage, abnormal foot structure, or wearing shoes that aren’t well suited for running. The morning pain upon rising is usually the worst, with relief coming later in the day as the ligament relaxes from its stretched position.
When plantar fasciitis is left untreated for an extended period of time, the acute inflammation subsides as the ligament adapts to the stress. Although that may be reassuring to hear, the reality is that even minor nerve damage can result in chronic pain.

Orthotics, regular stretching, and cortisone injections have all been used in the past to treat this condition, but recent research has shown that cortisone may actually exacerbate the disease by dissolving the foot’s fat pad.

Numerous studies have shown that amniotic tissue is effective in treating Amniotic tissue, obtained from the umbilical cord and other postpartum remnants, is injected into the injured area to stimulate the body’s natural healing. Due to the treatment’s reliance on short-term inflammation, patients may experience worsening of their symptoms as the injury heals. With Botox, however, patients rarely report any discomfort. If you’ve read the studies and found the possible benefits interesting, you might start recommending this treatment to your patients who have plantar fasciitis and a nerve problem.

The Science Behind Botox

Made from a very diluted form of the botulism toxin, Botox prevents nerve impulses from being sent between the brain and the muscles. Patients may be able to heal on their own over time with the help of stretching exercises and this medication, which helps relax the tissues around the plantar fascia but does not slow the healing process like cortisone. While many patients only need a single injection to see improvement, those with more severe symptoms may need to repeat the process every three months.

What the Research Shows

In a number of published medical studies, botox injections have been found to be more effective than placebos or steroids. Patients treated with Botox in a small study recovered from their injuries more quickly and remained healthy for a longer period of time than those treated with steroids. Compared to injecting steroids, which can cause plantar fascia rupture in as many as 6% of patients, this method has fewer side effects and is overall safer.

What to Look for to Determine If It Suits You

Botox injections are a viable option if non-steroidal therapies like physical therapy, orthotics, and rest have been unsuccessful. While the typical recovery time for most treatments is around six weeks, the majority of the doctor’s patients are able to return to their workouts three to seven days after receiving injections.

Since Botox has not been approved by the FDA for the treatment of plantar fasciitis, many insurance providers may be initially reluctant to cover the expense (which could reach $500 per treatment), and it may be more challenging to find a doctor who will use it or has experience using it (since fewer doctors are willing to use it). The millions of runners, hikers, and other outdoor sports who deal with the discomfort may find the expense and inconvenience to be worthwhile.

Assuming the FDA greenlights Botox for plantar fasciitis, Perler thinks it could also be used to treat Achilles tendinitis, plantar fibromatosis, and chronic exertional compartment syndrome, all of which are common complaints among runners.

Because Botox lingers in the part of the body where it is injected, adverse effects such as muscle stiffness, neck or back discomfort, and itching are exceedingly rare when Botox is injected to treat plantar fasciitis.

The best thing this treatment might do is make your foot smoother and less wrinkled.