Comparison Between Platelet Rich Plasma (PRP) Injections and Corticosteroids for the Treatment of Chronic Plantar Fasciitis

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Abstract

Introduction: Plantar fasciitis is a common cause of heel pain. It is a clinical diagnosis, with patients classically experiencing particularly severe pain with the first few steps in the morning. Although it is often a self-limiting condition, the severity of the pain warrants medical attention. Symptoms will subside more quickly if risk factors are addressed and various treatment approaches are initiated as soon as possible. Objective: The aim of this study was to evaluate and compare the clinical effectiveness of platelet-rich plasma (PRP) versus corticosteroid (Cs) injections in the treatment of chronic plantar fasciitis. Methods: This prospective randomized comparative study was conducted over 12 months at Ghazi Al-Hariri Hospital and Baghdad Medical City. The study included 40 patients with chronic plantar fasciitis (symptoms > 3 months) who had failed conservative therapy. Participants were randomly assigned to two groups: Group I (PRP): Received 5–6 ml of PRP. Group II (Cs): Received 40 mg of methylprednisolone. Pain was evaluated using the Numeric Pain Rating Scale (NPRS) at rest and during movement at baseline, 1 day, 10 days, and 1 month post-injection. Results: Both groups demonstrated a significant reduction in pain scores and improved functional outcomes as time progressed. While pain decreased in both cohorts, the corticosteroid group experienced a more rapid improvement compared to the PRP group. A statistically significant difference favoring the steroid group was found at 10 days post-injection during movement (p=0.02). However, by the one-month follow-up, no statistically significant difference in pain relief was observed between the two groups. Additionally, the study noted that female gender and higher body weight were associated with significantly higher pain scores. Conclusion: Both PRP and corticosteroid injections are effective treatments for providing symptomatic relief in chronic plantar fasciitis. Corticosteroids appear to offer faster short-term pain reduction, particularly within the first 10 days following intervention.