Chronic Plantar Fasciitis: Effect of Platelet-Rich Plasma, Corticosteroid, and Placebo

Abstract

Plantar fasciitis is a common cause of heel pain. It is a disabling disease in its chronic form. It is a degenerative tissue condition of the plantar fascia rather than an inflammation. Various treatment options are available, including nonsteroidal anti-inflammatory drugs, corticosteroid injections, orthosis, and physiotherapy. This study compared the effects of local platelet-rich plasma, corticosteroid, and placebo injections in the treatment of chronic plantar fasciitis. In this double-blind study, patients were divided randomly into 3 groups. Local injections of platelet-rich plasma, corticosteroid, or normal saline were given. Patients were assessed with the visual analog scale for pain and with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot score before injection, at 3 weeks, and at 3-month follow-up. Mean visual analog scale score in the platelet-rich plasma and corticosteroid groups decreased from 7.44 and 7.72 preinjection to 2.52 and 3.64 at final follow-up, respectively. Mean AOFAS score in the platelet-rich plasma and corticosteroid groups improved from 51.56 and 55.72 preinjection to 88.24 and 81.32 at final follow-up, respectively. There was a significant improvement in visual analog scale score and AOFAS score in the platelet-rich plasma and corticosteroid groups at 3 weeks and at 3-month follow-up. There was no significant improvement in visual analog scale score or AOFAS score in the placebo group at any stage of the study. The authors concluded that local injection of platelet-rich plasma or corticosteroid is an effective treatment option for chronic plantar fasciitis. Platelet-rich plasma injection is as effective as or more effective than corticosteroid injection in treating chronic plantar fasciitis.

Conservative Treatment of Plantar Fasciitis and Posterior Heel Pain: A Review

“…The platelet-rich plasma (PRP) injections got similar results to the corticosteroids injections, according to the studies of Shetty et al [63] and Aksahin et al [64]. Mahindra et al [62] and Monto et al [61] even showed better outcomes than those obtained with the corticosteroids injection at a mean follow-up of 3 months and 2 years, respectively. Furthermore, there are no evidence of side effects for platelet-rich plasma injection, even if more studies are necessary to optimize the treatment.…”

“…In a randomized controlled single-blinded study, Monto et al [61] found that platelet-rich plasma injection was more effective and durable than corticosteroid injection at 2 years of follow-up. Mahindra et al [62] found that platelet-rich plasma injection had significantly better outcomes compared with corticosteroid injection, based on AOFAS score (American Orthopedic Foot and Ankle Score), at 3 months of follow-up.…”

Study of safety and efficacy of autologous platelet rich plasma combined with fractional CO2 laser in the treatment of post acne scars: a comparative simultaneous split-faces study

“…However, the application of autologous PRP in pain management has been well-documented. [27][28][29] Infect, a study done by Mishra et al shows that PRP was superior to bupivacaine in pain relief for patients suffering from elbow tendinopathy. 30 …”

Efficacy of intralesional corticosteroid versus autologous platelet rich plasma injection in the management of chronic plantar fasciitis

“…Other studies have reported superior results of PRP over corticosteroid therapy. 13,33 A recent study has reported both the therapies to be equally effective. 22 Others also have reported equal efficacy for both PRP and corticosteroid therapy.…”

“…However the duration of follow-up was for a longer time; 2 years in one study. 33 Ultrasonographic evaluation is commonly employed for to assess the thickness of the plantar fascia and is of diagnostic significance. 34 The thickness improved in both the groups.…”