Corticosteroid, Platelet-Rich Plasma, and Ozone Injections for Sinus Tarsi Syndrome

J Am Podiatr Med Assoc. 2023 Jan-Feb;113(1):20-221. doi: 10.7547/20-221.


Background: Sinus tarsi syndrome is characterized by permanent pain on the anterolateral side of the ankle due to chronic inflammation characterized by fibrotic tissue remnants and synovitis accumulation after repeated traumatic injuries. Few studies have documented the outcome of injection treatments for sinus tarsi syndrome. We sought to determine the effects of corticosteroid and local anesthetic (CLA), platelet-rich plasma (PRP), and ozone injections on sinus tarsi syndrome.

Methods: Sixty patients with sinus tarsi syndrome were randomly divided into three treatment groups: CLA, PRP, and ozone injections. Outcome measures were visual analog scale, American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS), Foot Function Index, and Foot and Ankle Outcome Score before injection compared with 1, 3, and 6 months after injection.

Results: At the end of months 1, 3, and 6 after injection, significant improvements were observed in all three groups compared with baseline (P < .001 for all). At months 1 and 3, improvements in AOFAS scores were similar in the CLA and ozone groups; those in the PRP group were lower (P = .001 and P = .004, respectively). At month 1, improvements in Foot and Ankle Outcome Score were similar in the PRP and ozone groups and higher in the CLA group (P < .001). At 6-month follow-up, there were no significant differences in visual analog scale and Foot Function Index results among the groups (P > .05).

Conclusions: Ozone, CLA, or PRP injections could provide clinically significant functional improvement for at least 6 months in patients with sinus tarsi syndrome.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adrenal Cortex Hormones
  • Fasciitis, Plantar* / therapy
  • Humans
  • Ozone*
  • Platelet-Rich Plasma*
  • Treatment Outcome


  • Ozone
  • Adrenal Cortex Hormones

Supplementary concepts

  • Sinus Tarsi Syndrome