Background
/ OBJECTIVE: Plantar fasciitis is characterized by pain at heel, which aggravates on weight bearing after prolonged rest. Many modalities of treatment are used for the management of plantar fasciitis. Local steroid injection is often used. Many studies showed that steroid injection gives pain relief but its not long term. Recent literature showed pain relief and long-term effect of autologous platelet rich plasma injection as it induces healing. This study compared the effects of local injection of Platelet Rich Plasma and Corticosteroid injection in treatment of chronic planter fasciitis.
Methods
Patients with clinical diagnosis of chronic plantar fasciitis (more than six weeks) after failed conservative treatment and plantar fascia thickness more than 4mm were included in study. Patients with previous surgery for plantar fasciitis, active bilateral plantar fasciitis, diagnosis of vascular insufficiency or neuropathy related to heel pain, hypothyroidism and diabetics were excluded from study.
In this prospective double blind study 60 patients included are divided randomly into two groups. Patients in group-A received PRP injection and in group-B received steroid injection. Patients were assessed with visual analogue scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) score, before injection, at 6 weeks, 3 months and at 6 months follow-up. Plantar fascia thickness was assessed before and six months after treatment.
Results
Mean VAS in group-A and group-B decreased from 7.14 and 7.21 before injection to 1.41 and 1.93 at final follow-up, respectively. Mean AOFAS score in group-A improved from 54 to 90.03 and in group-B improved from 55.63 to 74.67 at 6 months follow-up. The improvement observed in VAS and AOFAS in statistically significant. At end of six months follow-up plantar fascia thickness reduced in both groups after treatment from 5.78 and 5.6 to 3.35 and 3.75 in group-A and in group-B respectively, and the difference is statistically significant.
Conclusions
Local injection of platelet rich plasma is an effective treatment option for chronic plantar fasciitis when compared to steroid injection and beneficial effect last for long term.