Clinical Efficacy of Botulinum Toxin in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Abstract

OBJECTIVE:

To evaluate the efficacy of botulinum toxin A (BTX-A) for the treatment of plantar fasciitis through a meta-analysis of randomized controlled trials (RCTs) focusing on pain and functional outcomes since current literature has supported a potential benefit of BTX-A.

DATA SOURCES:

The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched until December 2020 for RCTs reporting the effects of BTX-A injections on plantar fasciitis. The complementary literature search included Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, and greylit.org.

STUDY SELECTION:

Only RCTs assessing the effect of BTX-A injections on pain, functional improvement, or plantar fascia thickness in patients with plantar fasciitis were included. Multiple researchers carried out the screening process of the 413 records.

DATA EXTRACTION:

Data were extracted independently and in duplicate using a standardized data extraction format. Information was contrasted by a third observer.

DATA SYNTHESIS:

BTX-A injections resulted in significant pain relief (mean difference, -2.07 [95% CI, -3.21 to -0.93]; P=.0004; I2=97%) and functional improvement (standardized mean difference, 1.15 [95% CI, 0.39-1.91]; P=.003; I2=87%). A subanalysis indicated that pain relief was sustained at 12 months while functional improvement remained significant after 0-6 months. The results were not affected by a single study after sensitivity analysis. The site of injection and the use or not of ultrasound-guided injections may account for potential sources of interstudy heterogeneity.

CONCLUSIONS:

This meta-analysis suggests both a statistically significant and a clinically meaningful improvement on plantar fasciitis symptoms after BTX-A treatment.

• Authors: Carlos Acosta-Olivo, Luis E Simental-Mendía, Félix Vilchez-Cavazos, Víctor M Peña-Martínez, Jorge Elizondo-Rodíguez, Mario Simental-Mendía
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 103 Issue 2 Pg. 364-371.e2 (02 2022) ISSN: 1532-821X [Electronic] United States
• PMID: 34688605 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: Copyright © 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Chemical References

• Botulinum Toxins, Type A

Topics

• Botulinum Toxins, Type A (therapeutic use)
• Fasciitis, Plantar (drug therapy)
• Humans
• Pain (drug therapy)
• Randomized Controlled Trials as Topic
• Treatment Outcome