https://doi.org/10.1177/1071100718762406 Foot & Ankle International® 1–7 © The Author(s) 2018 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1071100718762406 journals.sagepub.com/home/fai Article Plantar fasciitis, which is often described as an overload of the plantar fascia, 16 is the most common cause of heel pain in adults. 37 It is characterized by gradual onset of sharp pain along the medial aspect of the heel that is worse with the first step taken in the morning or at the beginning of an activity and lessens as the person warms up. The etiology of plantar fasciitis is multifactorial and poorly understood. Poor bio- mechanics and variations in the structure of the foot 30 can lead to repeated microtrauma of the plantar fascia at its ori- gin, resulting in inflammation and degeneration. 6,25 Plantar fasciitis is more prevalent in sedentary individuals and also in athletes, as well as those participating in running sports. 16 Pohl et al 30 have shown that a lower arch height and greater vertical ground reaction force load rate were associated with a history of plantar fasciitis in female runners. The other risk factors associated with plantar fasciitis include reduced ankle dorsiflexion, increased body mass index (BMI), and work-related weightbearing activities. 24 Available treatments modalities for plantar fasciitis, such as plantar fascia stretching exercises, strapping, extracorpo- real shock wave therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), arch supports, and heel pads, are mainly aimed to reduce inflammation. Corticosteroid injections are often reserved for resistant plantar fasciitis after failure of conservative noninvasive interventions. They have been shown to effectively reduce the heel pain in patients with plantar fasciitis. 8,9,17 The potent anti-inflammatory effect of corticosteroids may hasten the process of pain relief. They can also inhibit fibroblast proliferation and ground sub- stance proteins. 23 However, the use of corticosteroid injec- tions for the treatment of plantar fasciitis has been shown to be associated with rupture of plantar fascia, infection, change in skin pigmentation, peripheral nerve injury, mus- cle damage, postinjection flare, and fat pad atrophy. 1,19,36,39 762406FAI XX X 10.1177/1071100718762406Foot & Ankle InternationalJain et al research-article 2018 1 NDMC Medical College & Hindu Rao Hospital, Delhi, India 2 Galway University Hospitals, Galway, Ireland Corresponding Author: Sumit Kumar Jain, MBBS, MRCS, MS(Ortho), MCh, NDMC Medical College & Hindu Rao Hospital, Malkaganj, Delhi, 110007, India. Email: jainsumit24@gmail.com Comparison of Plantar Fasciitis Injected With Platelet-Rich Plasma vs Corticosteroids Sumit Kumar Jain, MBBS, MRCS, MS(Ortho), MCh 1 , Kumar Suprashant, MBBS 1 , Sanjeev Kumar, MBBS, MS(Ortho) 1 , Arun Yadav, MBBS, MS(Ortho) 1 , and Stephen R. Kearns, MD, FRCS(Tr&Orth), FFSEM 2 Abstract Background: Plantar fasciitis is one of the most common causes of heel pain. This prospective study compared the efficacy of local injection of corticosteroids vs platelet-rich plasma (PRP) in the treatment of plantar fasciitis. Methods: Patients were randomly allocated into 2 groups of 40 each (group A and group B). Patients were treated with local corticosteroid injection in group A and autologous PRP injection in group B. Clinical assessment was done prior to the injection and at 1 month, 3 months, and 6 months following the injection, which included visual analog pain scale, subjective rating using the modified Roles and Maudsley score, functional outcome score by the Foot and Ankle Outcome Instrument (FAI) core scale, and the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale. Radiological assessment was done by measuring the thickness of the plantar fascia using ultrasonography. The mean age, sex, and body mass index of both groups were comparable. Results: Postinjection, there was significant improvement of visual analog score, modified Roles and Maudsley score, FAI core scale, AOFAS ankle-hindfoot score, and plantar fascia thickness in both the groups. However, with the numbers available, no significant difference in improvement could be detected between the above-mentioned variables in the 2 groups. Conclusion: We found that the treatment of plantar fasciitis with steroid or PRP injection was equally effective. Level of Evidence: Level II, prospective randomized comparative series. Keywords: heel, pain, platelet-rich plasma, steroid injection