Clinical and Ultrasonographic Trajectories after Platelet-Rich Plasma and Corticosteroid Injection for Chronic Plantar Fasciitis: A Six-Month Prospective Comparative Study

Background: Chronic plantar fasciitis is a common cause of persistent heel pain. Corticosteroid injection provides rapid symptomatic relief, whereas platelet-rich plasma (PRP) may offer a more sustained regenerative response. This study compared the clinical and ultrasonographic outcomes of PRP and corticosteroid injections in chronic plantar fasciitis. Material and Methods: This prospective, open-label, non-randomized comparative interventional study included 60 patients with chronic plantar fasciitis, with 30 patients each receiving PRP or corticosteroid injection. Pain was assessed using the Visual Analogue Scale (VAS), and functional outcome was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score at baseline, 6 weeks, 12 weeks and 6 months. Plantar fascia thickness was measured by ultrasonography at baseline and 6 months. Results: Baseline characteristics were comparable between the two groups. At 6 weeks, corticosteroid produced significantly better pain relief and functional improvement, with lower VAS scores (3.9±0.9 vs. 4.9±0.9; p<0.001) and higher AOFAS scores (84.0±4.6 vs. 78.2±4.9; p<0.001). At 12 weeks, the VAS difference was not significant, while AOFAS scores favored PRP. At 6 months, PRP demonstrated significantly lower VAS scores (1.9±0.7 vs. 3.2±0.9; p<0.001) and higher AOFAS scores (90.3±4.0 vs. 79.8±5.2; p<0.001). Plantar fascia thickness was also significantly lower with PRP at 6 months (3.38±0.42 vs. 3.81±0.55 mm; p=0.001). Conclusion: Corticosteroid injection provides greater short-term relief, whereas PRP offers superior sustained pain relief, functional recovery and ultrasonographic improvement at 6 months.

Keywords: Chronic plantar fasciitis; platelet-rich plasma; corticosteroid injection; visual analogue scale; AOFAS; plantar fascia thickness.