Corticosteroid Injection, Extracorporeal Shock Wave Therapy, and Radiofrequency Ablation for Chronic Plantar Fasciitis:

Comparative Efficacy of Corticosteroid Injection, Extracorporeal Shock Wave Therapy, and Radiofrequency Ablation for Chronic Plantar Fasciitis: A Prospective Randomized Controlled Trial

Chronic plantar fasciitis is a prevalent condition causing persistent heel pain, often refractory to conservative treatments. This prospective randomized controlled trial aimed to compare the effectiveness of corticosteroid injection (CSI) , extracorporeal shock wave therapy (ESWT), and radiofrequency thermal lesioning (RTL) in the management of chronic plantar fasciitis.

Based on the investigators' understanding of the literature there are no randomized, controlled, prospective studies comparing the therapeutic effects of CSI, ESWT and RTL for recalcitrant plantar fasciitis. In this study, the investigators investigated and compared the outcomes of three treatment techniques in participants who had exhausted conservative treatment options over the past six months.

Inclusion Criteria:

• Persistant heel pain for ≥ 6 months
• No response to at least 6 weeks of conservative treatment (including at least two of the following: NSAIDs, stretching exercises, ice, heel pads, physical therapy, or night splints)
• Age ≥ 18
• BMI ≤ 35
• VAS ≥ 5 following the first step in the morning or after periods of prolonged inactivity
• Willingness to participate in the study

Exclusion Criteria:

• Previous foot or ankle surgery, major trauma
• Tumor, osteomyelitis, or complex regional pain syndrome in the affected limb
• Allergy to local anesthesia or NSAIDs
• Pregnancy or breastfeeding
• History of calcaneal fracture
• Previous cortisone injection, ESWT, or RTL for similar complaints
• BMI >35
• Age < 18
• Use of medications for neuropathic pain (Pregabalin, Gabapentin)
• Proximal nerve lesion (e.g., spinal stenosis, sciatica, tarsal tunnel syndrome)
• Regional skin or subcutaneous infections, fat pad atrophy
• History of rheumatic disease, or hematologic conditions
• History of peripheral vascular disease
• Seronegative arthropathies, heart failure, hepatic or metabolic disorders
• Pacemaker
• History of clubfoot, pes cavus, or calcaneovalgus
• Diabetic neuropathy