Treatment of plantar fasciitis using four different local injection modalities: a randomized prospective clinical trial.

Background: To determine the effectiveness of four different local injection modalities in the treatment of plantar fasciitis. Methods: In a prospective randomized multicenter study of plantar fasciitis, 100 patients were divided into four equal groups and were treated using four different methods of local injection: group A was treated with 2 mL of autologous blood alone; group B, an anesthetic (2 mL of lidocaine) combined with peppering; group C, a corticosteroid (2 mL of triamcinolone) alone; and group D, a corticosteroid (2 mL of triamcinolone) combined with peppering. The outcome was defined by using a 10-cm visual analog scale and modified criteria of the Roles and Maudsley score 3 weeks and 6 months after the injection and compared with the pretreatment condition. Results: The successful results in all of the groups after injections were higher than those in the pretreatment condition (P = .000). In groups C and D, in which local corticosteroid injections were used, excellent results were obtained, with superior effect in the group in which peppering was used (P &amp;lt; .05). Conclusions: In the treatment of plantar fasciitis, combined corticosteroid injections and peppering is effective and produces better clinical results. (J Am Podiatr Med Assoc 99(2): 108–113, 2009)</jats:p