{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:24:48Z","timestamp":1789496688841,"version":"build-2803163510"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>The purpose of this meta-analysis was to evaluate the therapeutic efficacy and safety of botulinum toxin A (BTA) injections for treatment of plantar fasciitis (PF).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This review adhered to the PRISMA guidelines, conducting a comprehensive search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases for eligible studies from their inception to December 30 2023. The inclusion criteria were limited to randomized controlled trials (RCTs) comparing BTA injections with control interventions in terms of pain reduction, functional improvement, or the occurrence of adverse events in treating patients with PF were extracted for meta-analysis. Relevant data were extracted using an electronic spreadsheet and analyzed with Stata 16.0 software. The quality of included studies was assessed using the Cochrane Collaboration\u2019s tool.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 655 studies were retrieved and subsequently screened. Seven RCTs, comprising 305 participants, met the eligibility criteria and were included in the meta-analysis. The pooled results indicated that BTA injections led to significant pain reduction only at 1-month posttreatment (SMD = -1.72, 95% CI [-3.10, -0.34], p = 0.01]) and sustained functional improvement over twelve months (SMD = 25.10, 95% CI [9.67, 40.53], p = 0.001) compared to the control group. There was no significant difference in the occurrence of adverse events between the BTA and control interventions (OR = 0.16, 95% CI [-1.00, 1.32], p = 0.79).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This meta-analysis suggested that BTA injection could be an effective and safe therapeutic strategy for plantar fasciitis. However, further larger-scale, rigorously designed RCTs are needed to validate these findings and determine the optimal injection dosage and site for BTA in the treatment of plantar fasciitis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0312908","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T18:36:19Z","timestamp":1734460579000},"page":"e0312908","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Therapeutic efficacy and safety of botulinum toxin A injection in plantar fasciitis: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"given":"Qian","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengfei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2126-7614","authenticated-orcid":true,"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,17]]},"reference":[{"issue":"6","key":"pone.0312908.ref001","doi-asserted-by":"crossref","first-page":"372","DOI":"10.5435\/JAAOS-22-06-372","article-title":"Plantar and medial heel pain: diagnosis and management","volume":"22","author":"CR Lareau","year":"2014","journal-title":"J Am Acad Orthop Surg"},{"issue":"5","key":"pone.0312908.ref002","first-page":"227","article-title":"Economic burden of plantar fasciitis treatment in the United States.","volume":"39","author":"KB Tong","year":"2010","journal-title":"Am J Orthop (Belle Mead NJ)."},{"issue":"21","key":"pone.0312908.ref003","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1056\/NEJMcp032745","article-title":"Clinical practice. Plantar fasciitis","volume":"350","author":"R. Buchbinder","year":"2004","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0312908.ref004","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s12178-008-9036-1","article-title":"The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies.","volume":"2","author":"YZ Tatli","year":"2009","journal-title":"Curr Rev Musculoskelet Med"},{"issue":"2","key":"pone.0312908.ref005","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.fcl.2009.02.001","article-title":"Plantar heel pain.","volume":"14","author":"EP Toomey","year":"2009","journal-title":"Foot Ankle Clin"},{"issue":"12","key":"pone.0312908.ref006","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1001\/archinte.166.12.1305","article-title":"Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial","volume":"166","author":"KB Landorf","year":"2006","journal-title":"Arch Intern Med"},{"issue":"11","key":"pone.0312908.ref007","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1001\/jama.290.11.1474","article-title":"Effect of magnetic vs sham-magnetic insoles on plantar heel pain: a randomized controlled trial","volume":"290","author":"MH Winemiller","year":"2003","journal-title":"Jama"},{"issue":"7406","key":"pone.0312908.ref008","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1136\/bmj.327.7406.75","article-title":"Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial","volume":"327","author":"M Haake","year":"2003","journal-title":"Bmj"},{"key":"pone.0312908.ref009","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jcot.2020.09.002","article-title":"Comparison of midterm results of Platelet Rich Plasma (PRP) versus Steroid for plantar fasciitis: A randomized control trial of 118 patients.","volume":"13","author":"A Khurana","year":"2021","journal-title":"J Clin Orthop Trauma"},{"issue":"2","key":"pone.0312908.ref010","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/107110070602700210","article-title":"Consequences of partial and total plantar fascia release: a finite element study.","volume":"27","author":"JT Cheung","year":"2006","journal-title":"Foot Ankle Int"},{"key":"pone.0312908.ref011","doi-asserted-by":"crossref","first-page":"52","DOI":"10.12688\/f1000research.2-52.v2","article-title":"Use of botulinum toxin in musculoskeletal pain","volume":"2","author":"JA Singh","year":"2013","journal-title":"F1000Res."},{"issue":"4","key":"pone.0312908.ref012","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1097\/AJP.0000000000000538","article-title":"Efficacy of Intra-Articular Botulinum Toxin in Osteoarticular Joint Pain: A Meta-Analysis of Randomized Controlled Trials.","volume":"34","author":"M Courseau","year":"2018","journal-title":"Clin J Pain"},{"issue":"9","key":"pone.0312908.ref013","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/01.phm.0000176339.73591.d7","article-title":"Treatment of pain attributed to plantar fasciitis with botulinum toxin a: a short-term, randomized, placebo-controlled, double-blind study","volume":"84","author":"MS Babcock","year":"2005","journal-title":"Am J Phys Med Rehabil"},{"issue":"2","key":"pone.0312908.ref014","doi-asserted-by":"crossref","first-page":"136","DOI":"10.2340\/16501977-0491","article-title":"Ultrasonographic guided botulinum toxin type A treatment for plantar fasciitis: an outcome-based investigation for treating pain and gait changes","volume":"42","author":"YC Huang","year":"2010","journal-title":"J Rehabil Med"},{"issue":"7","key":"pone.0312908.ref015","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1177\/0269215511426159","article-title":"Randomized controlled study of the efficacy of the injection of botulinum toxin type A versus corticosteroids in chronic plantar fasciitis: results at one and six months.","volume":"26","author":"IV D\u00edaz-Llopis","year":"2012","journal-title":"Clin Rehabil"},{"issue":"6","key":"pone.0312908.ref016","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/AJP.0b013e31823ae65a","article-title":"Is botulinum toxin A effective for the treatment of plantar fasciitis?","volume":"28","author":"CD Peterlein","year":"2012","journal-title":"Clin J Pain"},{"issue":"21","key":"pone.0312908.ref017","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.3109\/09638288.2015.1114036","article-title":"Comparison of extracorporeal shock wave therapy with botulinum toxin type A in the treatment of plantar fasciitis","volume":"38","author":"B Roca","year":"2016","journal-title":"Disabil Rehabil"},{"key":"pone.0312908.ref018","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"339","author":"D Moher","year":"2009","journal-title":"BMJ (Clinical research ed)."},{"issue":"10","key":"pone.0312908.ref019","first-page":"Ed000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions.","volume":"10","author":"M Cumpston","year":"2019","journal-title":"Cochrane Database Syst Rev."},{"issue":"7414","key":"pone.0312908.ref020","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"JP Higgins","year":"2003","journal-title":"Bmj"},{"issue":"3","key":"pone.0312908.ref021","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1093\/biostatistics\/1.3.247","article-title":"Meta-analysis, funnel plots and sensitivity analysis.","volume":"1","author":"J Copas","year":"2000","journal-title":"Biostatistics"},{"issue":"1","key":"pone.0312908.ref022","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1177\/1071100719875220","article-title":"Outcomes of Ultrasound-Guided Gastrocnemius Injection With Botulinum Toxin for Chronic Plantar Fasciitis.","volume":"41","author":"M Abbasian","year":"2020","journal-title":"Foot Ankle Int."},{"key":"pone.0312908.ref023","article-title":"Treatment of Plantar Fasciitis With Botulinum Toxin.","volume":"1","author":"J Ahmad","year":"2016","journal-title":"Foot & Ankle International."},{"issue":"2","key":"pone.0312908.ref024","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.fas.2023.10.004","article-title":"Botulinum toxin A versus platelet rich plasma ultrasound-guided injection in the treatment of plantar fasciitis: A randomised controlled trial.","volume":"30","author":"IM Ruiz-Hern\u00e1ndez","year":"2024","journal-title":"Foot Ankle Surg"},{"issue":"3","key":"pone.0312908.ref025","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.coph.2004.12.006","article-title":"Botulinal neurotoxins: revival of an old killer","volume":"5","author":"C Montecucco","year":"2005","journal-title":"Curr Opin Pharmacol"},{"issue":"1","key":"pone.0312908.ref026","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s10194-016-0651-8","article-title":"Therapeutic efficacy and safety of Botulinum Toxin A Therapy in Trigeminal Neuralgia: a systematic review and meta-analysis of randomized controlled trials","volume":"17","author":"ME Morra","year":"2016","journal-title":"J Headache Pain"},{"key":"pone.0312908.ref027","first-page":"307","article-title":"Botulinum toxin: application, safety, and limitations","volume":"364","author":"H. Bigalke","year":"2013","journal-title":"Curr Top Microbiol Immunol"},{"issue":"1\u20132","key":"pone.0312908.ref028","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.pain.2003.10.008","article-title":"Subcutaneous administration of botulinum toxin A reduces formalin-induced pain","volume":"107","author":"M Cui","year":"2004","journal-title":"Pain"},{"issue":"5","key":"pone.0312908.ref029","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/j.neuro.2005.01.017","article-title":"Review of a proposed mechanism for the antinociceptive action of botulinum toxin type A","volume":"26","author":"KR Aoki","year":"2005","journal-title":"Neurotoxicology"},{"issue":"2","key":"pone.0312908.ref030","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.apmr.2021.10.003","article-title":"Clinical Efficacy of Botulinum Toxin in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials","volume":"103","author":"C Acosta-Olivo","year":"2022","journal-title":"Arch Phys Med Rehabil"},{"issue":"30","key":"pone.0312908.ref031","doi-asserted-by":"crossref","first-page":"e34461","DOI":"10.1097\/MD.0000000000034461","article-title":"Clinical efficacy of botulinum toxin type A in the treatment of fasciitis pain: A systematic review and meta-analysis","volume":"102","author":"TT Li","year":"2023","journal-title":"Medicine (Baltimore)."},{"issue":"3","key":"pone.0312908.ref032","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1177\/1071100720961093","article-title":"Comparison of Botulinum Toxin A, Corticosteroid, and Anesthetic Injection for Plantar Fasciitis.","volume":"42","author":"J Elizondo-Rodr\u00edguez","year":"2021","journal-title":"Foot Ankle Int."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312908","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T18:36:28Z","timestamp":1734460588000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312908"}},"subtitle":[],"editor":[{"given":"Nilg\u00fcn","family":"Bek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,17]]},"references-count":32,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0312908","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,17]]}}}