The Comprehensive Systematic Review of Platelet-rich Plasma Injections for Chronic Plantar Fascilitis
Keywords:
Platelet-rich plasma, plantar fasciitis, corticosteroid, regenerative medicine, heel painAbstract
Introduction: Chronic plantar fasciitis (PF) often fails conservative treatment. Corticosteroid (CS) injections provide rapid but temporary relief, while platelet-rich plasma (PRP) offers a regenerative approach. This systematic review compares the efficacy and safety of PRP versus other treatments for chronic PF.
Methods: We systematically reviewed randomized controlled trials comparing PRP injections to any control for chronic PF (symptoms ≥3 months). Outcomes included pain (VAS), function (AOFAS), imaging changes, and adverse events.
Results: From RCTs (>5,000 patients), and primary studies, a consistent temporal pattern emerged: CS provided faster pain relief at 2–6 weeks, but PRP demonstrated superior and sustained improvements from 3 to 24 months. Key significant positive findings include: at 6 months, PRP was superior to CS for pain (VAS 3.71 vs. 5.40, p<0.0001) (26) and at 24 months for function (AOFAS 92 vs. 56, p=0.001) (4). Meta-analyses confirmed PRP superiority at 3 and 6 months (p=0.01–0.02) (11). PRP produced greater plantar fascia thickness reduction (3.53 vs. 4.58 mm, p<0.001) (45). The safety profile markedly favored PRP (only temporary post-injection pain) versus CS (skin depigmentation, fat pad atrophy, infection) (23). PRP was comparable to surgery with faster recovery (14,15) and superior to extracorporeal shockwave therapy at 90 days (12), dry needling (62), and botulinum toxin (68).
Discussion: PRP’s delayed but durable effect aligns with its regenerative mechanism (growth factor-mediated tissue remodeling), whereas CS provides only temporary anti-inflammatory suppression.
Conclusion: For chronic PF, PRP provides superior, longer-lasting pain relief and functional improvement compared to CS, with an excellent safety profile. PRP should be preferred over repeated CS and considered before surgery.
References
Kumar D, Koramutla HK (2018) Efficacy of intralesional corticosteroid versus autologous platelet rich plasma injection in the management of chronic plantar fasciitis. International Journal of Research in Orthopaedics. https://doi.org/10.18203/ISSN.2455-4510.INTJRESORTHOP20183683
Shetty SH, Dhond A, Arora M, Deore S (2019) Platelet‐Rich Plasma Has Better Long‐Term Results Than Corticosteroids or Placebo for Chronic Plantar Fasciitis: Randomized Control Trial. Journal of Foot and Ankle Surgery. https://doi.org/10.1053/j.jfas.2018.07.006
Thora A, Tiwari A, Bhatnagar N, Mohindra M (2018) Efficacy of platelet rich plasma in comparison to steroid for the management of chronic plantar fasciitis. International Journal of Research in Orthopaedics. https://doi.org/10.18203/ISSN.2455-4510.INTJRESORTHOP20181671
Monto R (2014) Platelet-Rich Plasma Efficacy Versus Corticosteroid Injection Treatment for Chronic Severe Plantar Fasciitis. Foot & ankle international. https://doi.org/10.1177/1071100713519778
Kukreja T, Agarwal T, Singh AK, Bhugra H (2017) Comparative study for the treatment of plantar fasciitis by corticosteroids versus platelet rich plasma. Medical Journal of Dr DY Patil University. https://doi.org/10.4103/MJDRDYPU.MJDRDYPU_109_16
Yannam RSH (2023) A Comparative Study between Single Dose Intralesional Corticosteroid and PRP Injection in Chronic Plantar Fascitis - A Long Term Follow-Up Study. International Journal of Science and Research (IJSR). https://doi.org/10.21275/sr221231181702
Peerbooms J, Lodder P, Oudsten BDD, et al (2019) Positive Effect of Platelet-Rich Plasma on Pain in Plantar Fasciitis: A Double-Blind Multicenter Randomized Controlled Trial. American Journal of Sports Medicine. https://doi.org/10.1177/0363546519877181
Jain K, Murphy P, Clough T (2015) Platelet rich plasma versus corticosteroid injection for plantar fasciitis: A comparative study. The Foot. https://doi.org/10.1016/j.foot.2015.08.006
Jain K, Clough T (2015) PLATELET RICH PLASMA VERSUS CORTICOSTEROID INJECTION FOR PLANTAR FASCIITIS: A COMPARATIVE STUDY. Journal of Bone and Joint Surgery-british Volume
Zuo A, Gao C, Jia Q, et al (2025) Platelet-Rich Plasma Versus Corticosteroids in the Treatment of Plantar Fasciitis. American Journal of Physical Medicine & Rehabilitation. https://doi.org/10.1097/PHM.0000000000002677
Seth I, Bulloch G, Seth N, et al (2023) The role of corticosteroid injections in treating plantar fasciitis. The Foot. https://doi.org/10.1016/j.foot.2023.101970
Pandey S, Kumar N, Kumar A, et al (2023) Extracorporeal Shockwave Therapy Versus Platelet Rich Plasma Injection in Patients of Chronic Plantar Fasciitis: A Randomized Controlled Trial From a Tertiary Center of Eastern India. Cureus. https://doi.org/10.7759/cureus.34430
Yalçin Ü (2020) Plantar Fasiit Tedavisinde Trombosit Zengin Plazma ve Ekstrakorporeal Şok Dalga Tedavisinin Etkinliğinin Karşılaştırılması. https://doi.org/10.30565/medalanya.566188
Atzmon R, Eilig D, Dubin J, et al (2022) Comparison of Platelet-Rich Plasma Treatment and Partial Plantar Fasciotomy Surgery in Patients with Chronic Plantar Fasciitis: A Randomized, Prospective Study. Journal of Clinical Medicine. https://doi.org/10.3390/jcm11236986
Ragab E (2018) A comparative study between endoscopic plantar fasciotomy and platelet-rich plasma for treatment of resistant plantar fasciitis. The Egyptian Orthopaedic Journal. https://doi.org/10.4103/eoj.eoj_65_18
Nepal S, Gupta MK, Panthee R, et al (2024) Effectiveness of corticosteroid injection vs platelet rich plasma (PRP) injection in the treatment of plantar fasciitis. Birat Journal of Health Sciences. https://doi.org/10.62065/bjhs465
Acosta-Olivo C, Elizondo-Rodríguez J, Lopez-Cavazos R, et al (2017) Plantar Fasciitis-A Comparison of Treatment with Intralesional Steroids versus Platelet-Rich Plasma A Randomized, Blinded Study. Journal of the American Podiatric Medical Association (Print). https://doi.org/10.7547/15-125
akşahin E, Doğruyol D, Yüksel HY, et al (2012) The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis. Archives of Orthopaedic and Trauma Surgery. https://doi.org/10.1007/s00402-012-1488-5
Willits K, Kaniki N, Bryant D, et al (2017) Autologous Conditioned Plasma (ACP) versus Corticosteroid Injections for Plantar Fasciitis: A Randomized Trial. Orthopaedic Journal of Sports Medicine. https://doi.org/10.1177/2325967117S00222
Malahias M, Mavrogenis A, Nikolaou V, et al (2019) Similar effect of ultrasound-guided platelet-rich plasma versus platelet-poor plasma injections for chronic plantar fasciitis. The Foot. https://doi.org/10.1016/j.foot.2018.11.003
Valotto-Junior E, Silva SB, Muniz LHG, et al (2023) A randomized study comparing the effect of platelet-rich plasma and platelet-poor plasma for the treatment of plantar fasciitis. Research, Society and Development. https://doi.org/10.33448/rsd-v12i9.43168
Uğurlar M, Sönmez M, Uğurlar ÖY, et al (2018) Effectiveness of Four Different Treatment Modalities in the Treatment of Chronic Plantar Fasciitis During a 36‐Month Follow‐Up Period: A Randomized Controlled Trial. Journal of Foot and Ankle Surgery. https://doi.org/10.1053/j.jfas.2018.03.017
Vellingiri K, S. N, V MP, et al (2022) A Prospective Study Comparing the Efficacy of Local Injection of Platelet-Rich Plasma (PRP) vs Methylprednisolone in Plantar Fasciitis. Cureus. https://doi.org/10.7759/cureus.25523
Turchin O, Osadchaya L, Kostrub O, Lyabakh A (2019) Application of platelet rich plasma in the treatment of pain syndrome in patients with plantar fasciitis. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS. https://doi.org/10.15674/0030-59872019185-90
Kothari U, Shah S, Pancholi D, Chaudhary C (2024) Efficacy and Safety of Platelet-Rich Plasma Injection for Chronic Plantar Fasciitis: A Prospective Study on Functional Restoration and Pain Relief. Cureus. https://doi.org/10.7759/cureus.52414
Kumar K, Rao V, Panda A, et al (2024) Comparison of Platelet-Rich Plasma and Corticosteroid Injections for Chronic Plantar Fasciitis: A Randomized Controlled Trial. Cureus. https://doi.org/10.7759/cureus.59656
Upadhyay S, Damor V (2018) Autologous platelet rich plasma versus corticosteroid injection for chronic plantar fasciitis: a prospective controlled randomized comparative clinical study. International Journal of Research in Medical Sciences. https://doi.org/10.18203/2320-6012.IJRMS20181430
P S, Kv N, Rp R, et al (2019) Is Platelet-rich Plasma Injection more Effective than Steroid Injection in the Treatment of Chronic Plantar Fasciitis in Achieving Long-term Relief? Malaysian Orthopaedic Journal. https://doi.org/10.5704/MOJ.1911.002
Gonnade N, Bajpayee A, Elhence A, et al (2018) Regenerative efficacy of therapeutic quality platelet-rich plasma injections versus phonophoresis with kinesiotaping for the treatment of chronic plantar fasciitis: A prospective randomized pilot study. Asian Journal of Transfusion Science. https://doi.org/10.4103/ajts.AJTS_48_17
Gogna P, Gaba S, Mukhopadhyay R, et al (2016) Plantar fasciitis: A randomized comparative study of platelet rich plasma and low dose radiation in sportspersons. The Foot. https://doi.org/10.1016/j.foot.2016.08.002
Homayouni K, Karimian H, Golkar H, Jalalati N (2016) Treatment of Chronic Plantar Fasciitis with Ultrasound-Guided Injection of Platelets Rich Plasma. Journal of Archives in Military Medicine. https://doi.org/10.5812/JAMM.42332
Patil P, Chanchpara G, Gunaki R, et al (2017) Platelet rich plasma for plantar fasciitis: Is it a hype??? International Journal of Orthopaedics Sciences. https://doi.org/10.22271/ORTHO.2017.V3.I2D.33
Khandaker MdN, Islam MdM, Emran MA, et al (2023) Impacts of Ultrasonogram-Guided, Intra-fascial, Autologous, Activated Platelet-Rich Plasma Injection in Chronic Plantar Fasciitis: A Quasi-experimental Study. Cureus. https://doi.org/10.7759/cureus.34659
Bildik C, Kaya O (2022) Platelet-Rich Plasma vs Autologous Blood Injection to Treat Plantar Fasciitis: A Prospective Randomized, Double-Blinded, Controlled Trial. Foot & ankle international. https://doi.org/10.1177/10711007221114122
K.G. S, Solankey RD, Singh M, et al (2023) Comparative study of local injections of autologous platelet rich plasma versus corticosteroid in management of chronic plantar fasciitis. Journal of Clinical Orthopaedics and Trauma. https://doi.org/10.1016/j.jcot.2023.102225
Khurana A, Dhankhar V, Goel N, et al (2020) Comparison of midterm results of Platelet Rich Plasma (PRP) versus Steroid for plantar fasciitis: A randomized control trial of 118 patients. Journal of Clinical Orthopaedics and Trauma. https://doi.org/10.1016/j.jcot.2020.09.002
Singh V, Assat RP, Singhal A, Silayach R (2023) A comparative prospective study of platelet rich plasma versus corticosteroid injection in chronic plantar fasciitis. International Journal of Research in Orthopaedics. https://doi.org/10.18203/issn.2455-4510.intjresorthop20231990
Johnson-Lynn S, Cooney A, Ferguson D, et al (2019) A Feasibility Study Comparing Platelet-Rich Plasma Injection With Saline for the Treatment of Plantar Fasciitis Using a Prospective, Randomized Trial Design. Foot & Ankle Specialist. https://doi.org/10.1177/1938640018776065
Chakravarthy HYR, Sherikar N, Rawal N, et al (2024) A Comparative Study between Platelet-rich Plasma and Corticosteroid Injection for Plantar Fasciitis. Journal of Orthopaedic Diseases and Traumatology. https://doi.org/10.4103/jodp.jodp_77_23
Hafez A, Ismail FM, Abdelhakeem MA, et al (2023) Musculoskeletal Ultrasound Changes in Chronic Plantar Fascia after Treatment with Platelet Rich Plasma Compared to Steroid. Muscle Ligaments and Tendons Journal. https://doi.org/10.32098/mltj.01.2023.14
Senthilnathan A, Prabhakar R, Shankar K, Balaji P (2022) A comparative study to analyse the efficacy of platelet rich plasma versus corticosteroids in the treatment of chronic plantar fasciitis. International Journal of Orthopaedics Sciences. https://doi.org/10.22271/ortho.2022.v8.i1b.2991
Puri V, Gaur A (2019) A comparative study between local injection of autologous platelet rich plasma and injection of corticosteroid in functional improvement of plantar fasciitis. International Surgery Journal. https://doi.org/10.18203/2349-2902.isj20190809
Dwivedi A, Dagar V, Kumar A, Sachdev T (2019) Comparative analysis between platelet rich plasma and corticosteroid injection in plantar fasciitis. Santosh University Journal of Health Sciences. https://doi.org/10.18231/j.sujhs.2019.010
Sakharkar NS, Tathe P, Jain P, et al (2023) Prospective Comparative Short-Term Study of Autologous Leucocyte-Rich Platelet-Rich Plasma vs. Local Steroids in Chronic Plantar Fascitis. International Journal of Recent Surgical and Medical Sciences. https://doi.org/10.1055/s-0043-1761456
Gosavi R, Madke AS, Chadchan DB (2024) EFFECT OF PLATELET-RICH PLASMA VERSUS STEROID INJECTION IN PLANTAR FASCIITIS. Indian Journal Of Applied Research. https://doi.org/10.36106/ijar/0305418
Balashanmugam A, Kothimbakkam P, Bharath V, et al (2023) A randomized controlled comparative study of functional outcome of chronic refractory plantar fasciitis treated with platelet-rich plasma injection and corticosteroid injection. Journal of Orthopaedics and Spine. https://doi.org/10.4103/JOASP.JOASP_25_22
Shah H, Prabhakaran A, Praveen I, Farook U (2025) A Comparative Study of Platelet-Rich Plasma V/S Corticosteroid Injection for Plantar Fasciitis. Journal of Pharmacy and Bioallied Sciences. https://doi.org/10.4103/jpbs.jpbs_263_25
Wang X, Zhang D, Zhang F, et al (2021) Comparing Platelet-Rich Plasma Injections with Extracorporeal Shock Wave Therapy for Chronic Plantar Fasciitis: A Prospective Comparative Study. https://doi.org/10.21203/rs.3.rs-718755/v1
Dijoo MM, Rakshan I, Shafi F (2021) Management of Plantar Fasciitis using Platelet Rich Plasma vs Corticosteroids: A Comparative Study. International Journal of Science and Research (IJSR). https://doi.org/10.21275/mr211113110807
Ravikant U, Kumar A, Sajid I, et al (2022) A comparative study between platelet-rich plasma, corticosteroid, and autologous whole blood injection in patient of plantar fasciitis. Journal of Bone and Joint Diseases. https://doi.org/10.4103/jbjd.jbjd_29_22
Breton A, Leplat C, Picot M, et al (2021) Prediction of clinical response to corticosteroid or platelet-rich plasma injection in plantar fasciitis with MRI: A prospective, randomized, double-blinded study. Diagnostic and Interventional Imaging. https://doi.org/10.1016/j.diii.2021.10.008
Johnson-Lynn S, Cooney A, Ferguson D, et al (2016) Pilot randomised controlled trial of platelet-rich plasma versus normal saline for plantar fasciitis. Journal of Bone and Joint Surgery-british Volume
Mohammed DAR, Salman ProfIA, Ismail DEA (2026) Comparison Between Platelet Rich Plasma (PRP) Injections and Corticosteroids for the Treatment of Chronic Plantar Fasciitis. International Journal of Pharmaceutical and Bio-Medical Science. https://doi.org/10.47191/ijpbms/v6-i3-05
Karabulut Ç, Kılınçoğlu V, Tekin S, Gönder N (2025) A Prospective Randomized Comparison of Platelet-Rich Plasma, Corticosteroid, and Dry Needling Therapies for Plantar Fasciitis: Clinical Outcomes at 6 Months. European Journal of Therapeutics. https://doi.org/10.58600/eurjther2733
Monto R (2012) Platelet-rich plasma is more effective than cortisone for chronic plantar fasciitis
Monto R (2012) PLATELET RICH PLASMA IS MORE EFFECTIVE THAN CORTISONE INJECTION FOR CHRONIC PLANTAR FASCIITIS
Yoder A, Panzer TS (2018) Is moxibustion effective in reducing non-cephalic presentations at birth? Evidence-Based Practice. https://doi.org/10.1097/EBP.0000000000000084
Mahindra P, Yamin M, Selhi H, et al (2016) Chronic Plantar Fasciitis: Effect of Platelet-Rich Plasma, Corticosteroid, and Placebo. Orthopedics. https://doi.org/10.3928/01477447-20160222-01
Sherpy NA, Hammad M, Hagrass H, et al (2016) Local injection of autologous platelet rich plasma compared to corticosteroid treatment of chronic plantar fasciitis patients: A clinical and ultrasonographic follow-up study. The Egyptian Rheumatologist. https://doi.org/10.1016/J.EJR.2015.09.008
Singh M, Ummat A, Sharma C, et al (2019) Efficacy of Platelet-rich Plasma vs Corticosteroid Injection in Chronic Plantar Fasciitis: A Comparative Study. Journal of Foot and Ankle Surgery (Asia Pacific). https://doi.org/10.5005/jp-journals-10040-1097
Sawan ZH, El-Tohamy SA, Elhossieny KM, et al (2023) Analgesic efficacy and functional outcome in refractory cases of plantar fasciitis treated with platelet-rich plasma: randomized comparative study with corticosteroids injection. Egyptian Journal of Anaesthesia. https://doi.org/10.1080/11101849.2023.2224651
Mallah RE, Elattar E, Zidan H (2017) Platelet-rich plasma versus dry needling of myofascial meridian trigger points in the treatment of plantar fasciitis. Egyptian Rheumatology and Rehabilitation. https://doi.org/10.4103/1110-161X.205661
Sharma R, Chaudhary N, Karki M, et al (2023) Effect of platelet-rich plasma versus steroid injection in plantar fasciitis: a randomized clinical trial. BMC Musculoskeletal Disorders. https://doi.org/10.1186/s12891-023-06277-1
Srivastava V, Vishwas, Rathi R, et al (2022) PLANTAR FASCIITIS TREATMENT WITH PLATELET-RICH PLASMA INJECTION VERSUS STEROID INJECTION. Asian Journal of Pharmaceutical and Clinical Research. https://doi.org/10.22159/ajpcr.2022.v15i10.46342
Sherpy NA, Hammad M, Hagrass EH, et al (2016) SAT0523 Efficacy of Local Autologous Platelet Rich Plasma Injection Compared To Local Corticosteroid in Treatment of Plantar Fasciitis; An Ultrasonographic Evaluation. Annals of the Rheumatic Diseases. https://doi.org/10.1136/annrheumdis-2016-eular.4429
Sahoo P, Ujade N, Das S (2020) Effectiveness of single injection of platelet-rich plasma over corticosteroid in the treatment of plantar fasciitis – A randomized, comparative study. Journal of Musculoskeletal Surgery and Research. https://doi.org/10.4103/jmsr.jmsr_81_20
Chakrabarty S (2024) Comparison of Platelet Rich Plasma and Steroid Injection in the Treatment of Plantar Fasciitis. International Journal of Science and Research (IJSR). https://doi.org/10.21275/mr24206222109
Ruiz-Hernández IM, Gascó-Adrien J, Buen-Ruiz C, et al (2023) Botulinum toxin A versus platelet rich plasma ultrasound-guided injection in the treatment of plantar fasciitis: A randomised controlled trial. Foot and Ankle Surgery. https://doi.org/10.1016/j.fas.2023.10.004
Puri V, Gaur A (2019) A comparative study of effectiveness of local injection of autologous platelet rich plasma and injection corticosteroid solution in treatment of plantar fasciitis. International Journal of Research in Orthopaedics. https://doi.org/10.18203/ISSN.2455-4510.INTJRESORTHOP20190801
Alkhuzai A (2018) A prospective comparative study to compare orthobiological PRP platelet rich plasma intra lesional injectional therapy compare to steroid injection in treatment of Achilles tendonitis and intractable plantar fasciitis a clinical follow up study for 2 Years. International Journal of Orthopaedics Sciences. https://doi.org/10.22271/ortho.2018.v4.i2i.81
Goel N, Talwar J, Agarwal S, et al (2021) A comparative study between intralesional platelet rich plasma injection and extracorporeal shockwave therapy for the treatment of plantar fasciitis. Journal of Arthroscopy and Joint Surgery. https://doi.org/10.1016/J.JAJS.2021.04.003
Somasundaram AK, Pst J, Muthu S (2021) Is platelet rich plasma superior to corticosteroid injection for recalcitrant plantar fasciitis? Results of a prospective comparative study. https://doi.org/10.18231/J.IJOR.2020.014
Hoque MdJ, Zaman ME, Das RK, et al (2019) Platelet rich plasma is better than corticosteroid in longterm outcome in planter fasciitis: A study in a tertiary level teaching hospital at Dhaka, Bangladesh. Z H Sikder Women's Medical College Journal. https://doi.org/10.47648/zhswmcj.2020.v0102.03
Hada VS, Tiwari AK, Audichya T, Patni A (2024) The efficacy of platelet rich plasma therapy versus corticosteroid injection in the treatment of plantar fasciitis in adults: A randomised controlled trial. International Journal of Orthopaedics Sciences. https://doi.org/10.22271/ortho.2024.v10.i2b.3539
Krishnan A, Sharma Y, Singh S (2012) Evaluation of therapeutic effects of extracorporeal shock wave therapy in resistant plantar fasciitis patients in a tertiary care setting. Medical Journal Armed Forces India. https://doi.org/10.1016/j.mjafi.2012.01.007
Franceschi F, Papalia R, Franceschetti E, et al (2014) Platelet-rich plasma injections for chronic plantar fasciopathy. British Medical Bulletin. https://doi.org/10.1093/bmb/ldu025
Peerbooms J, Laar W van, Faber F, et al (2010) Use of platelet rich plasma to treat plantar fasciitis: design of a multi centre randomized controlled trial. BMC Musculoskeletal Disorders. https://doi.org/10.1186/1471-2474-11-69
Jiménez-Pérez AE, González-Arabio D, Díaz A, et al (2018) Clinical and imaging effects of corticosteroids and platelet-rich plasma for the treatment of chronic plantar fasciitis: A comparative non randomized prospective study. Foot and Ankle Surgery. https://doi.org/10.1016/j.fas.2018.01.005
Jain S, Suprashant K, Kumar S, et al (2018) Comparison of Plantar Fasciitis Injected With Platelet-Rich Plasma vs Corticosteroids. Foot & ankle international. https://doi.org/10.1177/1071100718762406
Patil V, Sharadrampure A (2024) Comparative Study of Ultrasound - Guided PRP Injection vs Steroid Injection in the Treatment of Plantar Fasciitis: A Two - Year Review of 100 Cases. International Journal of Science and Research (IJSR). https://doi.org/10.21275/sr24928114551
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Ayub Quisa, Zakiul Ifkar Hamsi, Frederich Gabriel Xaverius Butar Butar, Herfandi Dimas Anugrah (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
