Platelet-Rich Plasma Versus Corticosteroids in the Treatment of Plantar Fasciitis: A Systematic Review and Meta-analysis

Am J Phys Med Rehabil. 2025 Jul 1;104(7):613-621. doi: 10.1097/PHM.0000000000002677. Epub 2025 Jan 8.

Abstract

Objective: This study aims to compare the efficacy of platelet-rich plasma and corticosteroids in treating plantar fasciitis, focusing on pain relief, foot function, and plantar fascia thickness to identify the optimal treatment approach.

Design: A comprehensive search of medical databases was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, utilizing an extensive keyword strategy. Inclusion criteria encompassed prospective randomized controlled trials involving adult patients with plantar fasciitis treated with local platelet-rich plasma or corticosteroid injections, specifically assessing outcomes such as the visual analog scale, American Orthopedic Foot and Ankle Society scores, and plantar fascia thickness.

Results: The meta-analysis included 24 randomized controlled trials with 1653 participants. Platelet-rich plasma injections yielded significantly better visual analog scale scores compared to corticosteroid injections at 3 mos ( P = 0.03) and 6 mos ( P < 0.001), with no significant differences at 1 mo ( P = 0.12) and 12 mos ( P = 0.08). American Orthopedic Foot and Ankle Society scores demonstrated that platelet-rich plasma was superior to corticosteroid at 3 ( P = 0.05), 6 ( P < 0.001), and 12 mos ( P < 0.001), with no significant differences at 1 mo ( P = 0.31). Regarding plantar fascia thickness, there were no significant differences between platelet-rich plasma and corticosteroid at 1-1.5 mos ( P = 0.18), 3 mos ( P = 0.64), and 6 mos ( P = 0.05).

Conclusions: Platelet-rich plasma injections offer superior pain control compared to corticosteroids in the medium term (3-6 mos) but not in the short term or at 1 yr.

Keywords: Corticosteroids; Functional Improvement; Pain Relief; Plantar Fasciitis; Platelet-Rich Plasma.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Comparative Study

MeSH terms

  • Adrenal Cortex Hormones* / therapeutic use
  • Fasciitis, Plantar* / therapy
  • Humans
  • Pain Measurement
  • Platelet-Rich Plasma*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones