Plantar Fasciitis Steroid Injection Side Effects: Platelets Decimate Steroids in Effectively Treating Plantar Fasciitis

Plantar fasciitis steroid injection side effects? Plantar fasciitis is a problem involving the tough supporting structure on the bottom of the foot. It anchors in the heel and when this area is over loaded (or when nerves in the back are irritated), it can become sore and make it tough to walk (especially in the mornings). The usual treatment is injecting high dose steroids, but clinically we’ve seen that while this works for a while, the problem comes back with a vengeance. We and other physicians have been using concentrated platelets (platelet rich plasma [PRP] or our own SCP version) for years with very good results. So it was gratifying to see last week a research study that shows that not only did PRP work in a randomized controlled trial, it blew away steroids.

The study took 40 patients who had heel pain and a diagnosis of plantar fasciitis for 4 months who had not responded to conservative care and randomized them to get either a steroid or PRP shot. Ultrasound guidance was used to guide the injection and functional improvements on standardized questionnaires were tracked. The steroid group got about 60% better on a functional questionnaire by 3 months, fell to 40% better by 6 months, and were down to 15% better at 12 months after the shot. The PRP group tripled their function score (dramatically better-300%) by 3 months and kept almost all of those gains through the first year!

The upshot? Don’t let someone inject high dose steroids into your heel just because it’s covered by insurance. There is no evidence it works well and there are loads of studies that show it’s pretty toxic to tissues and tendon in particular. In addition, this latest study fits with what clinicians have observed for years, that steroids provide short lived pain relief and PRP can heal the problem!

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile