Platelet-rich plasma (PRP) or extracorporeal shockwave therapy for plantar fasciitis?
Plantar fasciitis is a very common cause of plantar pain which is prevalent among adults and can cause varying degrees of disability. Clinical presentations of plantar fasciitis could be a severe and sudden pain in the medial side of the heel especially early in the morning or the first gait after long term inactivity. Plantar fascia consists of connective tissue supporting the plantar arch and especially the longitudinal arch. Although the exact pathological causes of plantar fasciitis remain unknown, studies revealed varying degrees of micro inflammation and micro degenerative changes followed by fibrosis.
Conservative tractions, varying injections, shock therapies and also surgical treat are known as beneficial methods in non-responsive cases. In this recent study, they compared and evaluated the treatment of platelet rich plasma (PRP) injection and usage of extracorporeal shockwave therapy (ESWT) in pain reduction in patients with chronic plantar fasciitis.
This was a randomised clinical trial that was performed between 2017-2020 on patients with chronic plantar fasciitis who did not respond to standardised conservative therapies. A total number of 110 patients with plantar fasciitis were included and then divided into two groups. The data indicated no significant differences between the pains of patients before interventions. Pain evaluations were made in 2, 4, 8, 12, 16, and 24 weeks after interventions with controlling age and sex showed significantly reduced pain scores in both groups after interventions. We should also note that pain in the PRP group reduced more than ESWT group and this difference was also significant.
To conclude, the authors identified that PRP injections and ESWT are both beneficial in pain reduction in patients with chronic plantar fasciitis. However, they also indicated that PRP injections were associated with better long-term outcomes with pain reduction results compared to ESWT.
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