PRP for Plantar Fasciitis
Sep 29, 2025
Plantar fasciitis is one of the most common causes of heel pain, affecting many people each year. It involves inflammation, microtears, or degeneration of the plantar fascia — the thick band of tissue that runs along the bottom of the foot from the heel bone to the toes. Chronic plantar fasciitis can be stubborn and unresponsive to conventional therapies like stretching, orthotics, NSAIDs, and shockwave therapy.
In recent years, interest has grown in biologic or regenerative treatments, among which Platelet-Rich Plasma (PRP) has emerged as a potential option. In this post, we’ll explore what PRP is, how it may help plantar fasciitis, what the evidence says, how the procedure works, risks, and what to expect.
PRP stands for Platelet-Rich Plasma. In simple terms:
A 60 cc sample of the patient’s own blood is drawn.
The blood is centrifuged to separate and concentrate the platelets (and growth factors) from the rest of the blood.
The resultant plasma, enriched with platelets and signaling proteins, is injected into the injured tissue.
The rationale: platelets release growth factors (e.g. PDGF, TGF‑β, VEGF) that may enhance tissue repair, stimulate collagen synthesis, reduce inflammation, and recruit local stem or progenitor cells.
Because the source is your own blood (autologous), there’s less risk of immune reaction or rejection.
Here’s why PRP is attractive as a therapy for chronic plantar fasciitis:
Targeted regenerative stimulus — rather than simply suppressing pain, PRP aims to help tissue heal more effectively.
Minimally invasive — it’s done via injection always under ultrasound guidance.
Low risk of systemic side effects — since it’s your own blood, immunologic complications are rare.
Potential to avoid surgery — for patients who have failed conservative therapies, PRP is sometimes considered before more invasive procedures.
However, PRP is not a guaranteed cure, and its efficacy depends a lot on the technique, the severity of the plantar fasciitis, patient biology, and post‑procedure rehabilitation.
The evidence is still evolving, but some key findings and caveats stand out:
Some randomized and prospective studies have shown that PRP can lead to pain reduction and functional improvement in patients with chronic plantar fasciitis.
In many comparisons, PRP tends to offer more durable benefits than corticosteroid injections, especially in the mid to long term.
However, not all studies are consistent, and variations in PRP formulation (concentration, platelet activation, volume), injection technique (single vs multiple, ultrasound guidance, “peppering” technique), and patient selection make comparisons challenging. This is why identifying an expert is so important.
Meta-analyses and systematic reviews often caution that the quality of evidence is moderate, and high‑quality, large randomized controlled trials are still needed.
In short: the data is promising, but PRP is not (yet) a universally accepted standard of care.
Here is a typical workflow:
Consultation & Evaluation
Dr. Bhandari, a Regenerative Pain Medicine expert, assesses the foot, reviews imaging (ultrasound or MRI) to localize the damaged plantar fascia.
Blood Draw
Usually 60 mL of blood is drawn from the patient’s arm under sterile conditions.
Centrifugation / Processing
The blood is spun in a centrifuge to separate and concentrate the platelets. The specific protocol (spins, times, “double spin” vs “single spin”) can vary.
Injection (often ultrasound‑guided)
Using ultrasound to visualize the plantar fascia, the physician injects the PRP into or around the degenerated region. Some techniques use multiple small injections (“peppering”) to cover a broader area.
Post-Injection Protocol
Rest for a short period (days) from high-impact activities
Gradual reintroduction of stretching and strengthening
Physical therapy may complement the process
Monitoring and follow-up over weeks to months
Dr. Bhandari perform a single injection.
While PRP is generally safe, it’s important to be realistic and cautious:
Temporary pain or soreness at the injection site is common.
Infection risk — low but possible with any invasive procedure.
No guaranteed success — some cases may not respond.
Cost / insurance coverage — PRP is often considered experimental or elective, and many insurance plans may not cover it.
Technique-dependent efficacy — outcomes may depend heavily on how the PRP is prepared, injected, and the post-care plan.
Patient factors (age, severity of degeneration, comorbidities, smoking, BMI) influence results.
Here is a rough typical timeline (varies by individual):
| Timepoint | What May Happen |
|---|---|
| Week 0 (injection) | Some discomfort, swelling possible |
| Weeks 1–2 | Mild soreness, avoid high-impact loading |
| Weeks 2–6 | Gradual return to stretching, light loading |
| Weeks 6–12 | Many patients report pain reduction, improved function |
| 3–6 months | Full benefit often realized |
| 6–12 months | Sustained improvements (in successful cases) |
Many studies report that improvements may become more noticeable after the first few months, rather than immediately.
A middle-aged athlete who had 12 months of night pain, failed stretching, orthotics, shockwave therapy, but after one PRP injection saw ~50% pain relief by 3 months and ~80% by 6 months.
A patient with severe degenerative plantar fascia, failed surgery where PRP offered >50% relief and improvement on MRI.
Platelet-Rich Plasma (PRP) offers an exciting, biologically grounded option for patients with chronic plantar fasciitis who have not responded to conventional therapies. While the evidence is promising, PRP is not a guaranteed cure and its success depends on careful patient selection, precise technique, and a suitable rehabilitation plan.
If you're considering PRP, come in for a consult who is experienced with injection therapies for foot and ankle conditions!