Plantar Fasciitis - PRP (Platelet Rich Plasma) Treatment: A Solution for Heel Pain
Plantar fasciitis is one of the most common causes of heel pain, especially among runners, athletes, and those who spend long hours on their feet. While conventional treatments—such as stretching, orthotics, and physiotherapy offer relief, chronic cases may require advance therapies. One such innovative treatment is Platelet-Rich Plasma (PRP) therapy. Platelet-rich plasma (PRP) has been used as an alternative therapy for plantar fasciitis (PF) to reduce heel pain and improve functional restoration.
Anatomy and Pathophysiology of Plantar Fasciitis
The plantar fascia is a thick band of connective tissue extending from the heel bone (calcaneus) to the toes, supporting the arch of the foot. Microtears and collagen degeneration (rather than inflammation alone) characterize chronic plantar fasciitis, leading to persistent pain and dysfunction.
Causes:
Excessive running or jumping
Obesity or sudden weight gain
Flat feet or high arches
Tight calf muscles or Achilles tendon
Poor footwear or walking barefoot on hard surfaces
Prolonged standing (occupational hazard)
Signs & Symptoms
Sharp, stabbing heel pain (especially in the morning or after sitting)
Pain that worsens with activity
Tenderness at the heel base
Limited ankle dorsiflexion
Pain after long periods of standing
Conventional Treatment Options
Rest, ice, and NSAIDs
Stretching exercises (calf and plantar fascia)
Foot orthoses and night splints
Physiotherapy (taping, modalities such as shockwave therapy)
Corticosteroid injections - Ultrasound Guided
💉 What is PRP?
PRP (Platelet-Rich Plasma) is an injection made from the patient's own blood, rich in platelets and growth factors that support tissue healing.
How PRP Works in Plantar Fasciitis
Stimulates cellular repair
Encourages collagen production
Reduces chronic inflammation
Supports long-term regeneration
Evidence-Based Insights
Monto RR – A randomized controlled trial showed superior long-term outcomes of PRP over corticosteroids, with sustained pain relief up to 12 months.
Peerbooms JC et al. – PRP significantly improved outcomes for patients with chronic plantar fasciitis vs. corticosteroids at 24 weeks.
Koh et al. – Found ultrasound-guided PRP to be effective in restoring plantar fascia thickness and reducing pain.
Good Candidates
Failed conservative and conventional management
Chronic plantar fasciitis (usually more than 3 to 6 months)
Refractory plantar fasciitis (Recurring)
Active individuals wanting non-surgical healing
Procedure and Recovery
Preparation: Patients is usually advised to stop anti-inflammatory medications before the procedure to optimise PRP effectiveness.
Injection Process: Performed in an outpatient setting, often under ultrasound guidance for precision.
Post-Injection Care:
Rest for 24–48 hours.
Gradual return to activity with physiotherapy guidance.
Avoid NSAIDs, as they can interfere with the healing process.
Expected Timeline:
Initial pain relief may be noticed within a few weeks.
Full benefits typically seen over 3–6 months as tendon healing progresses.
Conclusion:
PRP therapy is a regenerative treatment that offers a biologically plausible and evidence-supported alternative for patients with plantar fasciitis. When combined with proper rehabilitation, it holds promise for long-term functional recovery.
References:
Acosta-Olivo, C., Elizondo-Rodriguez, J. I., Lopez-Gonzalez, F. M., Perez, J., Vilchez-Cavazos, F., Simental-Mendia, M., & Simental-Mendia, L. E. (2017). Platelet-rich plasma vs corticosteroids for the treatment of plantar fasciitis: A systematic review and meta-analysis. Foot & Ankle International, 38(6), 553–565.
Shetty, V. D., Moiyadi, A. V., Shetty, A., & Bhandari, M. (2020). Platelet-rich plasma injection for chronic plantar fasciitis – A prospective clinical study. Journal of Clinical Orthopaedics and Trauma, 11(5), 930–934.
Jain, S. K., Supe, A. M., & Bansal, M. (2021). Efficacy of platelet-rich plasma compared with corticosteroid injection in the treatment of chronic plantar fasciitis. Cureus, 13(9), e17977.
Marafko, M., Madeyski, K., & Derlatka, D. (2022). Ultrasound-guided platelet-rich plasma injection for the treatment of chronic plantar fasciitis. Journal of Ultrasonography, 22(89), e29–e35.
Singh, P., Madanipour, S., & Bhamra, J. S. (2019). A systematic review and meta-analysis of the use of platelet-rich plasma in the management of plantar fasciitis. Foot and Ankle Surgery, 25(4), 548–553.