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Application of platelet rich plasma in the treatment of pain syndrome in patients with plantar fasciitis

Olena Turchin, Lyudmila Osadchaya, Oleksandr Kostrub, Andrey Lyabakh


Objective: to analyze the results of the injection of plateletrich plasma (PRP) and prolonged-acting corticosteroids in patients with plantar fasciitis (PF).

Methods: 43 patients were examined (55 feet) with pain syndrome of PF. There were women 29, men — 14, average age (44 ± 1.41) years, average duration of the pain syndrome (3.5 ± 0.36) months. Together with the complex of conservative treatment for patients we prescribed locally injections: in group I (27 patients) — once 1 ml of betamethasone, in II group (16 patients) — PRP (2 ml three times with an interval of 7 days in the region of enthesis). The standard PRP method was used. The pain syndrome was evaluated with the help of VAS before, after 1, 3 and 6 months after treatment. Thickness of plantar aponeurosis (PA) was measured with sonography before and in 6 months after treatment.

Results: the average level of pain syndrome before the injections in the both groups were almost identical and amounted to (7.2 ± 0.17) and (7.3 ± 0.23) points, respectively. In a month after the injection in the Ist group, the pain syndrome significantly decreased to (3.5 ± 0.12) points, which confirms fast analgesic effect of manipulation. In the IInd group, the indicators of pain decreased to (4.6 ± 0.17) points. By 6 months the results were almost identical in both groups of patients. Thickness of PA before treatment was equal in the group І (6.62 ± 0.08) mm, in ІІ — (6.81 ± 0.1) mm, so there was no difference between them. After 6 months the thickness of PA was equally reduced in both groups: in the Ist — to (4.49 ± 0.07) mm, in the IInd — to (4.42 ± 0.09) mm, which is objective criterion for the positive therapeutic effect of both methods of treatment.

Conclusions: injections of PRP and prolonged-action corticosteroids provide the same positive results in the treatment of pain syndrome in patients with PF. Effect of corticosteroids is fast, but their use is limited due to a number of complications. The introduction of PRP helps to reduce pain syndrome and to normalize thickness of PA.


platelet-rich plasma; foot; plantar fasciitis; plantar aponeurosis


Franceschi, F., Papalia, R., Paciotti, M., Franceschetti, E., Di Martino, A., Maffulli, N., & Denaro, V. (2014). Obesity as a Risk Factor for Tendinopathy: A Systematic Review. International Journal of Endocrinology, 2014, 670262. doi:10.1155/2014/670262

Thing, J., Maruthappu, M., & Rogers, J. (2012). Diagnosis and management of plantar fasciitis in primary care. British Journal of General Practice, 62 (601), 443–444. doi:10.3399/bjgp12x653769

Waclawski, E. R., Beach, J., Milne, A., Yacyshyn, E., & Dryden, D. M. (2015). Systematic review: plantar fasciitis and prolonged weight bearing. Occupational Medicine, 65 (2), 97–106. doi:10.1093/occmed/kqu177

Li, S., Wang, K., Sun, H., Luo, X., Wang, P., Fang, S., & Sun, X. (2018). Clinical effects of extracorporeal shock-wave therapy and ultrasound-guided local corticosteroid injections for plantar fasciitis in adults. Medicine, 97 (50), e13687. doi:10.1097/md.0000000000013687

Li, X., Zhang, L., Gu, S., Sun, J., Qin, Z., Yue, J., & Gao, R. (2018). Comparative effectiveness of extracorporeal shock wave, ultrasound, low-level laser therapy, noninvasive interactive neurostimulation, and pulsed radiofrequency treatment for treating plantar fasciitis. Medicine, 97 (43), e12819. doi:10.1097/md.0000000000012819

Kim, C., Cashdollar, M. R., Mendicino, R. W., Catanzariti, A. R., & Fuge, L. (2010). Incidence of Plantar Fascia Ruptures Following Corticosteroid Injection. Foot & Ankle Specialist, 3 (6), 335–337. doi:10.1177/1938640010378530

Ragab, E. M., & Othman, A. M. (2012). Platelets rich plasma for treatment of chronic plantar fasciitis. Archives of Orthopaedic and Trauma Surgery, 132 (8), 1065–1070. doi:10.1007/s00402-012-1505-8

Martinelli, N., Marinozzi, A., Carnì, S., Trovato, U., Bianchi, A., & Denaro, V. (2012). Platelet-rich plasma injections for chronic plantar fasciitis. International Orthopaedics, 37 (5), 839–842. doi:10.1007/s00264-012-1741-0

Malahias, M., Mavrogenis, A. F., Nikolaou, V. S., Megaloikonomos, P. D., Kazas, S. T., Chronopoulos, E., & Babis, G. C. (2019). Similar effect of ultrasound-guided platelet-rich plasma versus platelet-poor plasma injections for chronic plantar fasciitis. The Foot, 38, 30–33. doi:10.1016/j.foot.2018.11.003

Shetty, S. H., Dhond, A., Arora, M., & Deore, S. (2019). Platelet-Rich Plasma Has Better Long-Term Results Than Corticosteroids or Placebo for Chronic Plantar Fasciitis: Randomized Control Trial. The Journal of Foot and Ankle Surgery, 58 (1), 42–46. doi:10.1053/j.jfas.2018.07.006

Kampa, R. J., & Connell, D. A. (2010). Treatment of tendinopathy: is there a role for autologous whole blood and platelet rich plasma injection? International Journal of Clinical Practice, 64 (13), 1813–1823. doi:10.1111/j.1742-1241.2010.02432.x

Amini, F., Chiew, S., & Ramasamy, T. (2016). Effectiveness and relevant factors of platelet-rich plasma treatment in managing plantar fasciitis:A systematic review. Journal of Research in Medical Sciences, 21 (1), 38. doi:10.4103/1735-1995.183988

Jiménez-Pérez, A. E., Gonzalez-Arabio, D., Diaz, A. S., Maderuelo, J. A., & Ramos-Pascua, L. R. (2018). Clinical and imaging effects of corticosteroids and platelet-rich plasma for the treatment of chronic plantar fasciitis: A comparative non randomized prospective study. Foot and Ankle Surgery, pii: S1268-7731(18)30023-7. doi:10.1016/j.fas.2018.01.005

WHO :: Global Database on Body Mass Index. (n.d.). Retrieved from

Sherpy, N. A., Hammad, M. A., Hagrass, H. A., Samir, H., Abu-ElMaaty, S. E., & Mortada, M. A. (2016). Local injection of autologous platelet rich plasma compared to corticosteroid treatment of chronic plantar fasciitis patients: A clinical and ultrasonographic follow-up study. The Egyptian Rheumatologist, 38 (3), 247–252. doi:10.1016/j.ejr.2015.09.008

Shetty, V. D., Dhillon, M., Hegde, C., Jagtap, P., & Shetty, S. (2014). A study to compare the efficacy of corticosteroid therapy with platelet-rich plasma therapy in recalcitrant plantar fasciitis: A preliminary report. Foot and Ankle Surgery, 20 (1), 10–13. doi:10.1016/j.fas.2013.08.002

Say, F., Gürler, D., Inkaya, E., & Bülbül, M. (2014). Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis. Acta Orthopaedica et Traumatologica Turcica, 48 (6), 667–672. doi:10.3944/aott.2014.13.0142

Jain, K., Murphy, P. N., & Clough, T. M. (2015). Platelet rich plasma versus corticosteroid injection for plantar fasciitis: A comparative study. The Foot, 25 (4), 235–237. doi:10.1016/j.foot.2015.08.006

Ragab, E. M., & Othman, A. M. (2012). Platelets rich plasma for treatment of chronic plantar fasciitis. Archives of Orthopaedic and Trauma Surgery, 132 (8), 1065–1070. doi:10.1007/s00402-012-1505-8

Chew, K. T., Leong, D., Lin, C. Y., Lim, K. K., & Tan, B. (2013). Comparison of Autologous Conditioned Plasma Injection, Extracorporeal Shockwave Therapy, and Conventional Treatment for Plantar Fasciitis: A Randomized Trial. PM&R, 5 (12), 1035–1043. doi:10.1016/j.pmrj.2013.08.590

Kalaci, A., Çakici, H., Hapa, O., Yanat, A. N., Dogramaci, Y., & Sevinç, T. T. (2009). Treatment of Plantar Fasciitis Using Four Different Local Injection Modalities. Journal of the American Podiatric Medical Association, 99 (2), 108–113. doi:10.7547/0980108

Gosens, T., Den Oudsten, B. L., Fievez, E., Van ‘t Spijker, P., & Fievez, A. (2012). Pain and activity levels before and after platelet-rich plasma injection treatment of patellar tendinopathy: a prospective cohort study and the influence of previous treatments. International Orthopaedics, 36 (9), 1941–1946. doi:10.1007/s00264-012-1540-7

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