Ultrasound-Guided Injection of Dextrose Versus Corticosteroid in Chronic Plantar Fasciitis Management: A Randomized, Double-Blind Clinical Trial

Foot Ankle Spec. 2023 Feb;16(1):9-19. doi: 10.1177/1938640020980924. Epub 2021 Jan 19.


Design: Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared.

Methods: A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups (P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group.

Conclusion: Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection.

Levels of evidence: Level II.

Keywords: RCT; corticosteroid; plantar fasciitis; ultrasound-guided.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living
  • Adrenal Cortex Hormones / therapeutic use
  • Chronic Pain* / drug therapy
  • Fasciitis, Plantar* / complications
  • Fasciitis, Plantar* / diagnostic imaging
  • Fasciitis, Plantar* / drug therapy
  • Glucose / therapeutic use
  • Humans
  • Treatment Outcome
  • Ultrasonography
  • Ultrasonography, Interventional


  • Adrenal Cortex Hormones
  • Glucose