Comparison of PRP Injections Versus Corticosteroid Injections in Plantar Fasciitis: Systematic Review and...

Plantar fasciitis (PF) is a common condition, affecting 10% of adults and accounting for 15% of foot pain consultations. Although 90% of cases resolve within 12 months with conservative treatments, chronic cases require more invasive treatments. Risk factors include a high body mass index and anatomical foot disorders. There is no standard treatment; options range from nonsteroidal anti-inflammatory drugs (NSAIDs) to surgery. Corticosteroids, while effective short term, can cause severe side effects. Platelet-rich plasma (PRP) has shown long-term effectiveness, alleviating pain and improving functionality.

This study, registered in PROSPERO and following PRISMA guidelines, searched for randomized clinical trials in PubMed, Scopus, Cochrane, and Web of Science comparing PRP with corticosteroids from 2019 to April 2024. It focused on patients with PF treated with PRP versus corticosteroids and their improvement in visual analog scale (VAS) pain scores. Randomized clinical trials were included, and the risk of bias was assessed using the Cochrane tool. Visual analog scale pain scores were analyzed using mean differences and a 95% CI. Heterogeneity was assessed with Q and I² tests. A random-effects model was used if significant heterogeneity was present; otherwise, a fixed-effects model was applied. Analysis was conducted with Review Manager 5.4.

Thirteen trials met the inclusion criteria, involving 901 subjects (497 with PRP and 404 with corticosteroids). In the short term, there were no significant differences in pain reduction (P = .85). In the medium term, PRP showed better results in VAS pain scores (P < .00001).

PRP is a safe and effective alternative for treating PF pain, with better results than corticosteroids in the medium term. Platelet-rich plasma is recommended as the preferred option in the management of chronic PF.