Effectiveness of single injection of platelet-rich plasma over corticosteroid in the treatment of plantar fasciitis – A randomized, comparative study

Abstract

Objectives: Plantar fasciitis (PF) is not an uncommon cause of heel pain whose treatment is not yet standardized. Although platelet-rich plasma (PRP) and corticosteroid (CS) injections are the two commonly used modalities, yet not much importance has been given to the comparison of their roles in sustained functional improvement. We aimed to study the effect of PRP and CS injections in PF and compare their effectiveness with respect to pain relief and improvement of functional and patient satisfaction. Methods: Seventy-three cases were randomized into two groups: 39 patients (Group A) received a single injection of autologous PRP and 34 in Group B received a single injection of CS (40 mg of methylprednisolone) by the random selection. A structured home exercise program was demonstrated to both the groups, as baseline management. The effectiveness was assessed and compared in preinjection and postinjection at 3- and 6-months follow-up. Visual Analog Scale (VAS), Roles and Maudsley (RM), and Foot Function Index (FFI) scoring systems were used as outcome measures. Results: CSs had an early effect, reducing pain to a moderate level in 82.4% of patients compared to PRP (P = 0.000). However, the effect was not sustainable over a long period. On the other hand, PRP was found to have better pain relief over 3 months and 6 months follow-up with a mean VAS score of 2.0 ± 0.9 and 0.8 ± 0.8, respectively (P = 0.000). There was a significant improvement of FFI and RM score as well as at 6 months follow-up (P = 0.000). Conclusion: Injection of CS had an early effect, which is not sustainable, whereas PRP was found to have a prolonged impact on pain relief and better patient satisfaction with treatment outcomes. Therefore, PRP can be advised for sustained and prolonged improvement in PF.