Comparative Effects of Platelet-Rich Plasma (PRP) and Corticosteroid(CS) Injection in the Treatment of Plantar Fasciitis
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Presenter(s)
Jaden Kramer and Noah Ziperski
Abstract
The Examination of Conservative Treatments on Plantar Fasciitis
Clinical Scenario: Plantar heel pain, most attributed to plantar fasciitis, is treated using several conservative and minimally invasive treatments. Among these, platelet-rich plasma (PRP) injections and corticosteroid injections (CSI) are two frequently used therapeutic interventions. This appraisal compares clinical outcomes associated with PRP and CSI to determine which treatment provides greater therapeutic benefit for adults experiencing plantar heel pain.
Focused Clinical Question: In an adult with plantar fasciitis, what is the effect of PRP injection compared to CSI in reducing pain as measured on a visual analog scale (VAS)?
Search Strategy:
A literature search was conducted using PubMed and JSTOR. Search terms included: “plantar fasciitis modalities,” “cupping plantar fasciitis,” “plantar fasciitis Graston,” “plantar fasciitis shockwave,” and “plantar fasciitis PRP” or “plantar fasciitis corticosteroid injection.” Studies were eligible if they involved adults aged 18–70 diagnosed with plantar fasciitis and evaluated PRP injection or CSI as treatment interventions. Studies were excluded if participants had a history of foot or ankle surgery, pregnancy, significant comorbid medical conditions, or functional impairments unrelated to plantar fasciitis. The search yielded seven studies that met the inclusion criteria and informed the clinical appraisal
Evidence Quality Assessment:
Four of the seven included studies scored ≥7/10 on the PEDro Scale, including one study that achieved a perfect score of 10/10. Based on the Oxford Levels of Evidence, six studies were classified as Level II, while one study was classified as Level III. Overall, the evidence demonstrates moderate to high methodological quality.
Results/Summary:
In 5 out of the 7 articles, CSI produced greater short‑term pain reduction, with mean VAS improvements of 3.0–4.5 points at 4–8 weeks (SD ±1.0–1.8) compared to PRP, which showed improvements of 1.5-3 points at week 4-8 (SD ± 0.5-1.4). Platelet‑rich plasma, however, demonstrated superior mid‑ to long‑term outcomes, with VAS reductions of 4.0–6.5 points at 6–12 months (SD ±1.2–2.0), compared with 2.0–3.5 points in CSI groups. 5 out of the 7 of the studies reported statistically significant between‑group differences favoring PRP at long‑term follow‑up (95% CIs excluding zero; p < 0.05). Limitations included studies that couldn’t retrieve follow-ups past six months, lack of participant size and a lack of a control group.
Clinical Bottom line:
Our findings weren’t conclusive in favoring one treatment over the other. Both CSI and PRP injections are effective treatment options for plantar heel pain. CSI provides greater short‑term pain relief, whereas PRP demonstrates more sustained long‑term improvement. Although the evidence consistently reflects this timing pattern, the overall strength of the literature supports a SORT Level B recommendation, indicating patient‑oriented evidence that is limited or mixed.
Implications:
CSI and PRP injections are both viable options for managing plantar fasciitis, with CSI offering short-term relief and PRP providing longer-term improvement. Clinicians should support shared decision-making by discussing these differences and aligning treatment with patient preferences. Future studies involving larger, more diverse samples and additional treatment comparisons are needed to strengthen and broaden the evidence base.
College
College of Nursing & Health Sciences
Department
Health, Exercise & Rehabilitative Sciences
Second Department
Health, Exercise & Rehabilitative Sciences
First Advisor/Mentor
Brandon Donahue
Second Advisor/Mentor
Nora Kraemer
Presentation Type
Oral Presentation
Format of Presentation or Performance
Pre-Recorded Video
Comparative Effects of Platelet-Rich Plasma (PRP) and Corticosteroid(CS) Injection in the Treatment of Plantar Fasciitis
The Examination of Conservative Treatments on Plantar Fasciitis
Clinical Scenario: Plantar heel pain, most attributed to plantar fasciitis, is treated using several conservative and minimally invasive treatments. Among these, platelet-rich plasma (PRP) injections and corticosteroid injections (CSI) are two frequently used therapeutic interventions. This appraisal compares clinical outcomes associated with PRP and CSI to determine which treatment provides greater therapeutic benefit for adults experiencing plantar heel pain.
Focused Clinical Question: In an adult with plantar fasciitis, what is the effect of PRP injection compared to CSI in reducing pain as measured on a visual analog scale (VAS)?
Search Strategy:
A literature search was conducted using PubMed and JSTOR. Search terms included: “plantar fasciitis modalities,” “cupping plantar fasciitis,” “plantar fasciitis Graston,” “plantar fasciitis shockwave,” and “plantar fasciitis PRP” or “plantar fasciitis corticosteroid injection.” Studies were eligible if they involved adults aged 18–70 diagnosed with plantar fasciitis and evaluated PRP injection or CSI as treatment interventions. Studies were excluded if participants had a history of foot or ankle surgery, pregnancy, significant comorbid medical conditions, or functional impairments unrelated to plantar fasciitis. The search yielded seven studies that met the inclusion criteria and informed the clinical appraisal
Evidence Quality Assessment:
Four of the seven included studies scored ≥7/10 on the PEDro Scale, including one study that achieved a perfect score of 10/10. Based on the Oxford Levels of Evidence, six studies were classified as Level II, while one study was classified as Level III. Overall, the evidence demonstrates moderate to high methodological quality.
Results/Summary:
In 5 out of the 7 articles, CSI produced greater short‑term pain reduction, with mean VAS improvements of 3.0–4.5 points at 4–8 weeks (SD ±1.0–1.8) compared to PRP, which showed improvements of 1.5-3 points at week 4-8 (SD ± 0.5-1.4). Platelet‑rich plasma, however, demonstrated superior mid‑ to long‑term outcomes, with VAS reductions of 4.0–6.5 points at 6–12 months (SD ±1.2–2.0), compared with 2.0–3.5 points in CSI groups. 5 out of the 7 of the studies reported statistically significant between‑group differences favoring PRP at long‑term follow‑up (95% CIs excluding zero; p < 0.05). Limitations included studies that couldn’t retrieve follow-ups past six months, lack of participant size and a lack of a control group.
Clinical Bottom line:
Our findings weren’t conclusive in favoring one treatment over the other. Both CSI and PRP injections are effective treatment options for plantar heel pain. CSI provides greater short‑term pain relief, whereas PRP demonstrates more sustained long‑term improvement. Although the evidence consistently reflects this timing pattern, the overall strength of the literature supports a SORT Level B recommendation, indicating patient‑oriented evidence that is limited or mixed.
Implications:
CSI and PRP injections are both viable options for managing plantar fasciitis, with CSI offering short-term relief and PRP providing longer-term improvement. Clinicians should support shared decision-making by discussing these differences and aligning treatment with patient preferences. Future studies involving larger, more diverse samples and additional treatment comparisons are needed to strengthen and broaden the evidence base.
