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March 2006 • www.rheumatologynews.com /CT Diseases 27 Single Injection May Quell Chronic Plantar

BY BRUCE JANCIN lief in nine such patients treated in open- try botulinum toxin A because of pub- greater than 4 on a 0-10 visual analog Denver Bureau label fashion. Based upon these highly en- lished reports citing its general scale. At week 2 this score was halved. At couraging results, a randomized, double- effect and inhibition of inflammatory . week 6 it was quartered. The same pattern V IENNA — Botulinum toxin A injection blind, and placebo-controlled clinical trial The nine patients selected for botu- of improvement was noted for maximum shows promise as a novel therapeutic op- is now planned, according to Dr. Placzek linum toxin A injection averaged age 55 pain during the previous 48 hours. tion for chronic patients of Charité Hospital, Berlin. years, with a 14-month history of plantar No muscle weakness or other adverse unresponsive to conventional treatments, Most patients with chronic plantar fasci- fasciitis refractory to all standard mea- events were observed, he noted at the Dr. Richard Placzek reported at the annual itis respond to physical therapy, cortico- sures. Follow-up evaluations were con- meeting sponsored by the European European Congress of . steroid injections, orthotics, acupuncture, ducted 2 weeks postinjection and every 1- League Against Rheumatism. Patients in- A single 200-unit injection into the and/or high-energy ultrasound extracor- 3 months thereafter up to 52 weeks. dicated they were satisfied with the pain painful region at the origin of the plantar poreal shock wave therapy. But not all do. At baseline, patients rated their mean relief they obtained and were pleased to fascia brought year-long marked pain re- Dr. Placzek and his coworkers decided to pain at rest during the past 48 hours as achieve it with a single injection. ■