Botox for Plantar Fasciitis in London

Most plantar fasciitis settles with stretching, supportive footwear and changes to activity, although it can take several months. For a small number of people, heel pain carries on despite this. Botox (botulinum toxin) is one of the options Dr Prashant Sankaye, Consultant MSK Radiologist, may discuss for stubborn plantar fasciitis. At LSRI it is given under ultrasound guidance, either into the tissues around the plantar fascia or into tight calf muscles that pull on the heel.

Who it may help

Botox may be considered if you have had heel pain from plantar fasciitis for many months and it has not improved enough with a structured stretching programme, footwear and insoles, or other injections. It is not usually the first treatment.

Before any treatment, an ultrasound scan confirms that the plantar fascia is the cause of your pain and checks for other causes, such as a problem with the heel fat pad, a nerve or a stress fracture. Read more about the condition on our plantar fasciitis page.

How Botox may help heel pain

• Calming pain: botulinum toxin may reduce the release of chemicals involved in pain signalling around the plantar fascia.
• Relaxing tight calf muscles: tight calves increase the pull on the heel and the plantar fascia. Relaxing them for a few months can reduce that strain while you stretch. Read more about Botox for calf tightness.

Small studies suggest that some people with long-standing plantar fasciitis have less pain and walk more comfortably after botulinum toxin, but the evidence is still limited and this is an off-label use. Unlike a steroid injection, it does not carry a risk of thinning the heel’s fat pad. Dr Sankaye will talk through whether it is likely to help you, alongside the other options such as steroid or PRP injections.

What to expect

1. Assessment: Dr Sankaye reviews your symptoms and previous treatment, examines your foot and calf, and scans the heel with ultrasound.
2. Injection: the skin is cleaned and Botox is injected through a fine needle, guided by ultrasound, into the planned area.
3. Afterwards: you can walk out of the clinic. You will be given aftercare advice and a stretching programme.
4. Recovery: any improvement usually builds over two to six weeks. A written report is sent to you and, if you wish, your GP or physiotherapist.

Risks and side effects

• pain, soreness or bruising at the injection site;
• temporary weakness of the small foot muscles or the calf, depending on where the injection is given;
• short-lived flu-like symptoms, which are uncommon;
• the pain not improving enough.

Botox may not be suitable if you are pregnant or breastfeeding, have myasthenia gravis or another condition affecting the nerves and muscles, have an infection where the injection would go, or take certain antibiotics (aminoglycosides). Please tell us about all your medicines, including blood thinners, before your appointment.

Seek urgent medical help if you have difficulty swallowing, speaking or breathing after a Botox injection. This is very rare.

Why choose LSRI

• Consultant-led care from Dr Prashant Sankaye, Consultant MSK Radiologist with more than 20 years’ experience.
• Diagnosis and ultrasound-guided treatment from the same specialist.
• Two clinics: LSRI Harley Street (W1G 9QJ) and LSRI Northwest London in Harrow (HA2 7SJ).
• No GP referral needed, and all major insurers accepted.

Frequently asked questions

Is Botox better than a steroid injection for plantar fasciitis?

They work differently. A steroid injection often gives quicker relief, while Botox avoids the risk of thinning the heel fat pad. Dr Sankaye will explain which option suits your situation.

Does the injection hurt?

The heel can be a sensitive area, so the injection may be uncomfortable for a short time. Ultrasound guidance helps keep it quick and accurate.

How long does the effect last?

It varies. For many people the aim is to calm the heel enough for stretching and strengthening to work, so that the improvement lasts after the Botox has worn off.

Other uses of Botox at LSRI

• Botox for calf tightness and foot spasticity
• Botox for trapezius and neck muscle pain
• Botox for muscle spasticity
• Botox for excessive sweating (hyperhidrosis)
• Can Botox help Raynaud’s phenomenon?

See all our Botox injections.

Book an appointment

Call 0203 633 5040 or book online. Clinics at LSRI Harley Street (The Harley Street Hospital, 19 Harley Street, London W1G 9QJ) and LSRI Northwest London (Medic Care Direct, 62 Station Road, Harrow HA2 7SJ).