These hard-to-heal sores can sometimes become so infected that the foot needs to be removed. Now, research funded by the National Institutes of Health will examine Botox in about 40 patients. Lead study author Mary Hastings, a physical therapist at Washington University, will recruit patients to join the study. Enrollment has not begun.

Botox will be injected into the calf muscle of people who have foot ulcers. The idea is that Botox will temporarily weaken the muscle. It's hoped Botox will weaken the muscle long enough to allow the pressure to decrease on the foot. Hastings says: "The wounds on the front of the foot are generally related to pressure, and that pressure is often highest during the push off part of walking, where you’re using that big muscle to propel you forward. What the [Botox] will do is weaken that muscle -- the muscle that pushes you forward during walking -- and so then you can’t develop high pressures on the front of your foot, which then will protect the tissue within. As strength returns, that tissue will become more tolerant."

Researchers will inject either 200 units or 300 units of Botox into six different sites in the calf muscle. Hastings hopes the research leads to better healing. She says: "The clinical indications are that the more time you spend without a sore on the bottom of a foot, the less chance you have for an infection that will develop into the potential for a need for an amputation. Really, our hope is that it helps prevent extreme interventions that people don’t want to pursue."

Neuropathy -- one of the most common complications of diabetes -- can be extremely painful and disabling. The goal of treatment is to relieve pain and discomfort and prevent additional tissue damage. Current treatments include pain medications, antidepressants, topical creams, nerve stimulation therapy, relaxation training and acupuncture.