A Systematic Review and Meta-Analysis in Local Steroid Injection versus Platelet-Rich Plasma Injection in Management of Plantar Fasciitis

Abstract

lantar fasciitis is a common and debilitating degenerative condition of the plantar fascia resulting from repetitive microtrauma and excessive strain on the plantar surface of the foot. Plantar fasciitis is the most common cause of plantar heel pain, and its prevalence is estimated up to 7% in the general population. Typically, the first-line treatment for plantar fasciitis is non-operative therapy with anti-inflammatory medication, shoe inserts, and physical therapy providing relief. This type of nonoperative treatment is successful in up to 90% of patients with the condition. In patients who do not respond to nonoperative treatment, injection therapies may be utilized. Corticosteroid (CS) injections have served as the traditional method of injection therapy for many years. CS injections are effective because of their inherent anti-inflammatory properties; however, they are also associated with a risk of plantar fascia rupture and fat pad atrophy. Furthermore, while CS may provide short-term pain relief, its long-term benefit in plantar fasciitis is questionable. Recently, advances in the concept of tissue repair have played a key role in the use of platelet-rich plasma (PRP) in treatment of multiple conditions. Platelet-rich plasma (PRP) has become increasingly utilized as a biologic option in the treatment of plantar fasciitis. Similar to CS, PRP has str