Plantar fasciitis is a common cause of heel pain and is the result of a 
degenerative process of the plantar fascia at its calcaneal attachment. A case 
study of a preliminary experience with local injections of botulinum toxin A 
(BTX-A) for the treatment of chronic plantar fasciitis in a 43-year-old woman is 
presented. We injected the patient with 70 units of BTX-A (0.7mL) in 2 divided 
doses: 40 units (0.4mL) in the tender region of the heel, and 30 units (0.3mL) 
in the most tender point of the foot arch. Visual analog scale (VAS) and 
pressure pain threshold (PPT) were measured to evaluate the efficacy of BTX-A 
injections. Real-time, high-resolution ultrasonographic findings of the plantar 
fascia after BTX-A injections were also used for serial follow-ups. After BTX-A 
injection, decreased VAS values were reported and increased PPT was observed. In 
ultrasonographic studies, the thickness of the plantar fascia and the 
hypoechogenicity of the fascia were reduced. Decreased plantar fascia thickness 
was observed on the first and third week after BTX-A injections. The findings 
were compatible with the changes in pain assessed by VAS and PPT. 
Ultrasonographic findings also indicated a progressive decrease in the thickness 
of the underlying muscle belly. Ultrasonography seems to be a valuable, 
noninvasive diagnostic tool for the evaluation of plantar fasciitis treated with 
BTX-A injections. It can offer objective measurements of therapeutic effects and 
is feasible for serial follow-ups.