Should You Get Neurotoxin or Filler for Foot Pain?

We all have a few pairs of shoes that, while we love, simply were not made for walking. If that’s your favorite look, it can come with some pretty debilitating pain. You wouldn’t be the first to wonder if Dr. Scholl’s is your only remedy.

In fact, interest in injectable neurotoxins and dermal fillers for pain has exploded since it became a common treatment option for chronic migraines. Of course, Botox and other neurotoxins have been used for pain management and muscle stiffness since it (Botox) was approved for such use in the late 80s. Dermal fillers, on the other hand, would add more cushion to the ball of the foot to reduce impact pain, in theory.

Since then, we’ve greatly expanded what can be injected and why.

If you’re experiencing chronic foot pain, you may be curious if neurotoxins or dermal filler could be your potential cure. We spoke with experts to learn how popular this treatment is and what to expect if you receive it.

Botox Does Work for Pain Management

When studying the effects of Botox on chronic neck and shoulder pain, researchers found that the nerve signals that process pain were blocked.

“Botox is in a class of medications called neurotoxins that, when injected into muscles, blocks the nerve signals that cause the tightening of muscle, leading to muscle relaxation. Thus, Botox may offer advantages over traditional therapies for myofascial pain syndrome due to its prolonged and sustained effects,” said study author Dr. Andrea Nicol, director of research at the UCLA Pain Management Center.

According to Miami plastic surgeon George Varkarakis, MD, Botox is very efficient at mitigating pain. “We use Botox and other neurotoxins for pain management all the time because it does work,” Dr. Varakarakis explains. “It could easily apply to the feet as well.”

There may be areas of the foot where a neurotoxin injection could ease your pain, but it won’t address what’s actually causing your pain.

Botox Could Cover a More Serious Issue

Spring, TX podiatrist and foot and ankle surgical specialist, Robert Moore III, DPM, has seen this kind of treatment rise in popularity recently, but doesn’t consider it a particularly valuable option. “Botox for the foot specifically is kind of a farce,” Dr. Moore III explains. “Paralyzing the muscle may reduce pain, but you could be crushing bunions or agitating a deformity further by not getting correct care, and I couldn’t do that to someone.”

Ultimately, Botox in the ball of your foot only goes so far.a

“Really, we want to know for sure that the pain you’re experiencing isn’t the result of something that needs more attention,” Dr. Moore III says. “And you need a podiatrist for that. There could be issues with your arch support that can be corrected with orthotics, or you might have a big toe that really drifts over towards the second toe – that would need to be surgically corrected.”

Dermal Filler in the Feet: All it’s Cracked Up to Be?

But what makes our feet unique?

According to New York podiatrist and foot and ankle surgical specialist Stuart Mogul, DPM, the primary issue with injecting anything into the bottom of the foot is just how much weight it carries every day. “The only problem is that they’re very temporary,” Dr. Mogul explains. “The loading force of the foot ends up dissipating those fillers within a month or two.”

When they are used, it’s typically in patients that have worn out the fat pad in the ball of their foot.

“When you have older patients or patients with very high arches in their feet, there’s a tendency for that fat pad to thin out,” Dr. Mogul says. “So, their metatarsal heads, or the ball of their foot, is more exposed to the ground. There’s a tremendous amount of force that goes through those bones and joints. When it comes to filler, you only have a month or two before it starts to move around.”

If you’re someone who has that kind of fat pad thinning on the ball of your foot, Dr. Varkarakis recommends doing what you’re comfortable with to achieve pain management. Just be aware of how long a neurotoxin will last.

“It may fade quickly, but Botox also fades quickly in the lips while still producing exceptional results,” Dr. Varkarakis explains. “It is an investment. But my advice is that if this works for you and relieves your pain, you should consider it. There is no contraindication for it.”

That said, both Dr. Moore III and Dr. Mogul suggest that getting to the root of the problem will benefit you more in the long-term.

“Some people swear by it, and good for them,” Dr. Moore III says. “But if you are experiencing consistent pain like that it’s likely the result of a deformity that needs to be addressed. Paralyzing the muscle may reduce pain, but it doesn’t fix the problem.”

And don’t worry, Dr. Scholl’s inserts aren’t your only remedy in the interim.

“We really recommend people with dissipating fat pads supplement externally with orthotics,” Dr. Mogul explains. “Those are materials that are specifically designed to absorb shock and behave as the perfect supplement to your natural fat pad.”

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