PRP vs Corticosteroids in Plantar Fasciitis: Meta-Analysis of 24 RCTs
(Am J Phys Med Rehabil 2025) · Am J Phys Med Rehabil (2025)
This meta-analysis represents one of the largest systematic analyses of PRP for plantar fasciitis, incorporating 24 RCTs with 1653 participants. The primary comparison was PRP versus corticosteroid injection. PRP demonstrated significant VAS superiority at 3 and 6 months and greater reduction in plantar fascia thickness. The study also characterized the geographic distribution of evidence (predominantly from India and Egypt) and the corticosteroid comparators used (mainly methylprednisolone and triamcinolone).
Clinical Relevance
Consolidates the strongest evidence base for PRP in any orthopedic condition outside of knee OA. Plantar fasciitis is now one of the best-supported indications for PRP injection. The low rate of ultrasound guidance use (22%) suggests outcomes may improve further with image guidance adoption.
Key Takeaways
- 24 RCTs, 1653 participants (largest plantar fasciitis PRP analysis)
- PRP superior to corticosteroid for VAS at 3 months (p=0.03) and 6 months
- PRP reduced plantar fascia thickness more than corticosteroid
- Most studies used methylprednisolone (n=16) or triamcinolone (n=4) as comparator
- PRP injection volumes ranged from 2 to 5 mL across studies
- Only 22% of studies used ultrasound guidance
- Geographic concentration: 14 from India, 4 from Egypt
Key Findings
Largest PF meta-analysis: 24 RCTs, 1653 participants. PRP superior VAS at 3 months (p=0.03) and 6 months. PRP also reduced plantar fascia thickness more than CS. Globally distributed studies (14 India, 4 Egypt, 1 each UK/Mexico/Iran/Turkey/Sri Lanka/Nepal).
Clinical Context
Study Design
Systematic Review and Meta-Analysis
Condition
Plantar Fasciitis
Sample Size
1653 patients
Follow-up
12 months
Control Group
Corticosteroid (16 methylprednisolone, 4 triamcinolone, others)
Primary Outcome
VAS, AOFAS, Plantar Fascia Thickness
PRP Protocol & Intervention
Preparation System
Various across 24 RCTs
Activation Method
2 studies used calcium gluconate
Injection Volume
2 mL
Injection Frequency
1 injection(s)