Efficacy of platelet rich plasma injection as an combined modality in reducing pain and improving functional outcome in plantar fasciitis - a randomized control trial

Background Plantar fasciitis is a common cause of chronic heel pain and functional limitation. While most patients respond to conservative treatment, refractory cases have led to increased interest in regenerative therapies such as platelet-rich plasma (PRP). This study evaluates the efficacy of PRP as an adjunct to physiotherapy compared with placebo in chronic plantar fasciitis. Methods A randomized controlled trial was conducted among 50 patients clinically and ultrasonographically diagnosed with plantar fasciitis. Participants were randomized into two groups: Group A received a 2 ml PRP injection, and Group B received a 2 ml normal saline placebo injection. Both groups underwent identical therapeutic ultrasound sessions and a structured 12-week plantar fascia stretching programme. Pain (Plantar Fasciitis Pain Score; PFPS), function (Foot and Ankle Ability Measure; FAAM), and plantar fascia thickness (ultrasonography) were assessed at baseline and follow-up intervals. Results The PRP group showed significantly greater improvement across all outcomes. PFPS reduced from 84.18 to 20.60 with PRP versus 77.42 to 27.24 with placebo. FAAM scores increased from 32.80 to 91.68 in the PRP group compared with 38.64 to 77.24 in the placebo group. Plantar fascia thickness decreased more in the PRP group (5.75 mm to 4.06 mm) than in the placebo group (5.70 mm to 5.00 mm). All improvements with PRP were statistically significant (p < 0.001). Conclusion PRP combined with physiotherapy yields superior pain relief, functional recovery, and structural improvement compared with placebo, supporting its role as an effective adjunct therapy for chronic plantar fasciitis.