Research Article
Volume 3 Issue 10 - 2020
Outcome of Corticosteroid Injection Versus Physical Therapy for the Treatment of Plantar Fasciitis. A Comparative Study
Zeehan Naeem1*, Imamuddin1, Anisuddin Bhatti2 and Nida Zeehan3
1Senior Registrar, Department of Orthopedic Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
2Professor/HOD, Department of Orthopedic Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
3Lecturer pathology dow university of health sciences karachi, Pakistan
*Corresponding Author: Zeehan Naeem, Senior Registrar, Department of Orthopedic Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
Received: August 22, 2020; Published: September 29, 2020


Objectives: To assess the effect of physical therapy and corticosteroid injections injection on the intensity of pain in patients with plantar fasciitis and compare them to find the better option for first-line management and thereafter, to clarify and improve the management protocol of plantar fasciitis with the acceptable and simplest way.

Materials and Methodology: This is a randomized controlled trial conducted at the Department of Orthopaedics, Jinnah Post Graduate Medical Centre (JPMC), Karachi, Pakistan, from 1st January to 31st December 2017. Group A 50 participants underwent physical therapy and Group B 50 participants were given a single dose 80 mg Depomedrol (corticosteroid) injection deep under the planter fascia at planter fascia attachment on calcaneus. All patients were followed up two weeks, four weeks and at three months interval. Outcomes were assessed in terms of the mean visual analog scale (VAS) score, compared between the two treatment groups, first prior to treatment (baseline) and then after three months (final).

Results: Out of a total of 100 patients, the mean age of patients was 41.83 ± 14.07 years. There were 62 males (53%) and 38 (47%) females. The mean duration of symptoms was 4.37 ± 4.81 weeks. Group A reported a mean VAS score of 3.62 ± 2.63 as compared to Group B reporting a mean score of 1.13 ± 1.24. A relatively greater improvement in final VAS (2.16 ± 1.97 from 7.51 ± 4.8) was observed in group A as compared to group B (2.97 ± 1.73 from 5.30 ± 4.7).

Conclusion: Long acting Corticosteroid injection has been sorted out as a better mode of treatment in comparison to physical therapy for short term symptomatic relief.

Although more comparative studies on larger scales are needed for labeling the best option and producing a centralized guideline for the treatment of plantar fasciitis.

Keywords: Corticosteroid Injection; Physical Therapy; Plantar Fasciitis


  1. Mahindra P., et al. “Chronic plantar fasciitis: Effect of platelet- rich plasma, corticosteroid, and placebo”. Orthopedic 2 (2016): e285-e289.
  2. Akhtar N RP and Ahmad Z. “Role of physical medicine and rehabilitation intervention for plantar fasciitis”. Pakistan Armed Forces Medical Journal 3 (2008): 239-243.
  3. Trojian T and Tucker A. “Plantar fasciitis”. American Family Physician 99 (2019): 744-750.
  4. Buchanan BK and Kushner D. “Plantar fasciitis” (2020).
  5. Jan WM. “Management of planter fasciitis”. Rawal Medical Journal 1 (2016): 1.
  6. Ang TW. “The effectiveness of corticosteroid injection in the treatment of plantar fasciitis”. Singapore Medical Journal8 (2015): 423-432.
  7. Sarfraz K TF., et al. “Effects of calcaneal taping, sham taping and stretching exercises in short term management of pain in plantar fasciitis”. Isra Medical Journal 5 (2017): 309- 315.
  8. Eslamian F., et al. “Extra corporeal shock wave therapy versus local corticosteroid injection in the treatment of chronic plantar fasciitis, a single blinded randomized clinical trial”. Pain Medicine9 (2016): 1722-1731.
  9. Neufeld SK and Cerrato R. “Plantar fasciitis: evaluation and treatment”. Journal of the American Academy of Orthopaedic Surgeons6 (2008): 338-346.
  10. Whittaker GA., et al. “Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis”. BMC Musculoskeletal Disorders1 (2019): 378.
  11. Verma D., et al. “Role of platelet-rich plasma versus corticosteroid injection in the treatment of plantar fasciitis: A comparative study”. Integrative Journal of Orthopaedics and Traumatology 2 (2019): 26.
  12. Crawford F., et al. “Steroid injection for heel pain: evidence of short- term effectiveness. A randomized controlled trial”. Rheumatology 10 (1999): 974-977.
  13. Atkins D., et al. “A systematic review of treatments for the painful heel”. Rheumatology 10 (1999): 968-973.
  14. Hill Jr J. “Survey on the use of corticosteroid injections by orthopaedists”. Contemporary Orthopaedics 18 (1989): 39-45.
  15. Pribut SM. “Current approaches to the management of plantar heel pain syndrome, including the role of injectable corticosteroids”. Journal of the American Podiatric Medical Association1 (2007): 68- 74.
  16. Johannsen FE., et al. “Corticosteroid injection is the best treatment in plantar fasciitis if combined with controlled training”. Knee Surgery, Sports Traumatology, Arthroscopy 1 (2019): 5-12.
  17. Majeed F., et al. “Comparison of vas pain score after infiltration of autologous blood injection versus corticosteroid injection for the treatment of plantar fasciitis”. Isra Medical Journal 4 (2019): 234-236.
  18. Liden B., et al. “A retrospective analysis of 22 patients treated with percutaneous radiofrequency nerve ablation for prolonged moderate to severe heel pain associated with plantar fasciitis”. Journal of Foot and Ankle Surgery6 (2009): 642-647.
  19. Tatli YZ and Kapasi S. “The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies”. Current Reviews in Musculoskeletal Medicine1 (2009): 3-9.
Citation: Zeehan Naeem., et al. “Outcome of Corticosteroid Injection Versus Physical Therapy for the Treatment of Plantar Fasciitis. A Comparative Study”.EC Orthopaedics 11.10 (2020): 49-54.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

December Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 21, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.