PRP vs Steroids for Plantar Fasciitis

Steroid injections for painful body parts are a medical standard that represents the worst of traditional medicine. Why? Steroids are toxic substances to the body that also happen to be powerful anti-inflammatories. Now the latest study of steroid injections versus platelet rich plasma (PRP) has hopefully put another nail in the proverbial steroid coffin. Let me explain.

What You’re Really Getting with an Injection of Steroids

Most patients are familiar with steroid injections, but most have no idea that PRP injections are an alternative to treat many of the same issues. It’s well known that steroids are bad news, but many patients agree to steroid injections in the hopes that the benefits will outweigh the risks. What you might not know is just how toxic these drugs really are. So let’s review what you’re really getting when you get a steroid injection.

Cartilage Damage

High-dose steroid injections destroy cartilage. That steroid injection into your knee, for example, might provide you with some temporary pain relief, but behind the scenes it’s wreaking havoc on your joint-cushioning cartilage. If you think you’re off the hook because your steroid injections are being injected into your foot for plantar fasciitis, think again. Your foot contains many tiny joints, all cushioned with cartilage to help provide smooth movement.

Diminishing Relief

Repeated steroid injections have been shown to provide diminishing relief with each subsequent injection. So while the first injection may provide some relief, the second provides less and the third even less and so on. Why? Possibly because of the toxic effect steroids have on the local repairing stem cells…

Poisoned Stem Cells

Your body’s own stem cells are powerful cells that respond to damage and immediately get to work repairing it when it occurs. One study found that when mesenchymal stem cells are exposed to steroids, this, in effect, poisons the cells, stifling their ability to become bone and to repair bone. With no strong stem cells to stop it, wear and tear sets in and bone damage occurs. In other words, the steroid-damaged local stem cells can’t keep up with their job of repairing. Even more disturbing, another study found that some steroids, even in smaller-than-typical doses, completely wiped out all of the local stem cells.

Increased Risk for Spinal Fractures

Bone loss and osteonecrosis are well-known potential risks of steroid treatments, but one you might not be as familiar with is fractures. It makes sense as weakened bone will lead to greater risks of fractures, but one study found that the risk for spine fracture increased with each steroid shot by a stunning 29%.

Decreased Blood Supply

In order to stay healthy and effectively heal, tissues need a good blood supply. One study, however, found that when comparing patients who were undergoing rotator cuff surgery and had steroid injections prior to the surgery to those who didn’t have steroids, the steroid patients had one-third fewer blood-supply vessels.

Adrenal Insufficiency

Hormone tests in one study provided evidence that 60% of patients who had steroid injections into their knees developed adrenal insufficiency. In many of these patients, the adrenal issue was still present two months after the steroid injection. Symptoms of adrenal insufficiency include depression, muscle fatigue, hypotension, kidney failure, and so on.

So if you have plantar fasciitis, is there an alternative for steroid injections? Yes! Platelet rich plasma, or PRP…

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What You’re Getting with an Injection of PRP

Platelet rich plasma (PRP) is concentrated from blood platelets, which are the body’s natural growth factors and healing molecules. When you have an open wound, such as a finger laceration or a skinned knee for example, it’s your platelets that rush in and start clotting your blood to stop the bleed. Your growth factors also kick in to encourage healing. It’s how the body heals itself when minor injuries occur.

To obtain PRP, blood is drawn from a vein and the whole blood is centrifuged, or rapidly spun. Centrifuging separates the plasma serum where the platelets are concentrated; hence, the result is a platelet rich plasma.

Injections of a patient’s own PRP stimulate the body’s local stem cells to wake up and start repairing damaged tissues. So PRP is like a shot of espresso for our repairman cells. PRP is used to treat many orthopedic conditions, such as muscle, ligament, and tendon tears, sprains, arthritis, and much more.

Our feature study today studied PRP vs steroids for plantar fasciitis and supports PRP as a safe, effective, and long-lasting solution over steroids for plantar fasciitis. Let’s take a look.

Study Favors PRP vs Steroids for Plantar Fasciitis

The purpose of the new study was to compare the impact of PRP versus steroid injections on chronic plantar fasciitis. Both outcomes and imaging (ultrasound and MRI) were analyzed in 40 patients with plantar fasciitis—20 received PRP and 20 received steroids. Subjects were evaluated at three and six months following treatment.

The results? While there were improvements in both groups, the PRP group showed significant improvement over the steroid group. Researchers concluded that PRP injections are a “more effective therapeutic method” than steroid injections. In addition, the study goes on to say that not only is PRP safe, but that PRP treatment provides a longer-lasting solution than steroids.

The upshot? This is one of many studies that now show that PRP is better than steroids and doesn’t have the nasty side effects. Now we just need insurance companies to get the memo! In the meantime, if you’re a patient who is getting or about to get a steroid injection, spend a little on yourself and upgrade to a PRP shot. You’ll be glad you did!

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

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NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.