Platelet-rich plasma or extracorporeal shockwave therapy for plantar fasciitis.

BACKGROUND: Plantar fasciitis is a common cause of plantar pain which is prevalent among adults. Conservative tractions, invasive injections, shock therapies and also surgical procedures are known as beneficial methods in non-responsive cases. Here we evaluated and compared the injection of platelet rich plasma (PRP) and usage of extracorporeal shockwave therapy (ESWT) in pain reduction in patients with chronic plantar fasciitis.

METHODS: This is a randomized clinical trial that was performed in 2017-2020 on patients with chronic plantar fasciitis who did not respond to conservative therapies. A total number of 110 patients with plantar fasciitis were entered based on inclusion and exclusion criteria. Patients were then divided into two groups. The pain of patients was measured using visual analogue scale (VAS) before interventions. The first group underwent PRP injections while the second group underwent ESWT using Shock Master 500. Patients were visited 2, 4, 8, 12, 16, and 24 weeks after interventions and the pain scores were noted using VAS.

RESULTS: Data of 104 patients were analyzed. Initial VAS scores of patients were also analyzed. These data indicated no significant differences between the pains of patients before interventions (P = 0.413). Pain evaluations in 2, 4, 8, 12, 16, and 24 weeks after interventions with controlling age and sex showed significantly reduced VAS scores in both groups after interventions (P = 0.002). We should also note that pain in the PRP group reduced more than ESWT group and this difference was also significant (P = 0.001).

CONCLUSION: Here we showed that PRP injections and ESWT are both beneficial in pain amelioration in patients with chronic plantar fasciitis. We also indicated that PRP injections were associated with better pain reduction results compared to ESWT.