Botulinum Toxin injections for plantar fasciitis

Your health care provider has diagnosed you with plantar fasciitis. This condition is due to irritation of the ligament that attaches to the heel and usually causes heel and sometimes arch pain.

Conservative treatment for this condition can include: stretches for the calf and foot, exercises, night splints, and foot orthotics. The majority of cases will improve with time. Some people with difficult to manage plantar fasciitis will have ongoing bothersome symptoms despite these treatments.

Until recently the only other available treatments were:

1. Cortisone injections at the heel (risk of ligament rupture)
2. Surgery

Recently a new treatment has been described whereby botulinum toxin (also known as Botox) is injected into the calf muscle.  This treatment temporarily weakens/relaxes this muscle and often leads to long term pain improvement. Studies have shown that when this muscle is excessively tight it puts undue stress on the other structures in the foot and ankle.

Possible side effects of botulinum toxin injection include:

1. Allergic reaction to the medication
2. Pain at the injection site
3. Skin infection
4. Mild flu-like reaction in 2% (feel generally unwell like the flu for 48 hours)

This treatment is contraindicated in patients with myasthenia gravis and in patients who have previously had an allergic reaction to this medicine.

As this is a new treatment it is not covered by most drug plans.  The cost of Botox is approximately $200 for each leg.  There is no cost for the consultation in my office or a tray fee.  These are covered by Manitoba Health. After your health care provider refers you to my office, you will be contacted by my office in order to arrange the Botox prescription.