Seventy-one patients with ≥2 months of persisting heel pain at the origin of the plantar fascia unresponsive to conventional therapies were randomized to receive a single injection of ropivacaine (5 mL; n=23), an intra-lesional injection of betamethasone sodium phosphate (1 mL; n=25), or an intralesional injection of 200 U of botulinum toxin A (BoNT-A; n=23) injection, administered using ultrasound-guidance. The outcomes of interest included the following: pain using the Visual Analogue Scale (VAS) and foot function using the Maryland Foot Score (MFS), evaluated at 2 weeks post-treatment as well as 1, 3, and 6 months post-intervention. Furthermore, fascia thickness was evaluated and dorsiflexion which were measured at 24 weeks follow-up. Results of this study demonstrated that only a statistical significant difference was observed between the BoNT vs. ropivacaine group at week 24 for MFS (p=0.0387). No other statistical differences were detected for VAS pain, fascia thickness, nor dorsiflexion scores between the three groups (p>0.05 for all).