A Prospective Study of Corticosteroid versus Platelet Rich Plasma Injection (PRP) In Chronic Plantar Fasciitis

Abstract

Background: Plantar fasciitis is a common cause of chronic heel pain that significantly affects mobility and quality of life. Although corticosteroid injections provide rapid symptomatic relief, their long-term effectiveness is limited. Platelet-rich plasma (PRP) has emerged as a regenerative treatment modality aimed at enhancing tissue healing. This study was conducted to compare the clinical outcomes of corticosteroid and PRP injections in patients with chronic plantar fasciitis.

Methods: A prospective comparative study was conducted involving 110 patients with chronic plantar fasciitis. Participants were divided into two groups of 55 patients each. Group A received corticosteroid injection, while Group B received PRP injection. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) score for functional assessment. Outcomes were evaluated at baseline, 4 weeks, 12 weeks, and 24 weeks after intervention. Treatment response, patient satisfaction, and complications were also recorded.

Results: Baseline demographic and clinical characteristics were comparable between both groups. Corticosteroid injection demonstrated greater pain reduction at 4 weeks (VAS: 3.9 ± 1.2 vs 4.5 ± 1.3; p=0.012). However, PRP showed significantly better pain outcomes at 12 weeks (3.4 ± 1.1 vs 4.3 ± 1.3; p<0.001) and 24 weeks (2.9 ± 1.2 vs 4.6 ± 1.4; p<0.001). Functional improvement was significantly higher in the PRP group at 12 and 24 weeks (AOFAS score 82.6 ± 7.9 and 87.4 ± 7.2, respectively; p<0.001). PRP-treated patients demonstrated higher satisfaction (87.3% vs 70.9%; p=0.041) and lower requirement for additional injections (3.6% vs 14.5%; p=0.049). Complication rates were comparable between groups.

Conclusion: Both corticosteroid and PRP injections are effective for chronic plantar fasciitis; however, PRP provides superior long-term pain relief, functional improvement, and patient satisfaction. PRP may be considered a promising regenerative treatment option for patients with persistent symptoms.