Background
Methods
Selection criteria
Search strategy
Data collection
Data handling and analysis
Assessment of study quality
Results
Trial | Intervention | Comparator | Cointerventions | Participants per group | Female participants (%) | Mean age (years) | Mean BMI (kg/m2) | Duration of symptoms (weeks)a | Trial duration (weeks) | Trial setting | |
---|---|---|---|---|---|---|---|---|---|---|---|
Intervention | Comparator | ||||||||||
Abdihakin (2012) [20] | Corticosteroid injection | Placebo injection | i) Oral anti-inflammatory drugs three times daily; ii) stretches; iii) foot orthoses; iv) heel splints; v) shoe recommendations | 44 | 38 | 52 | 42.9 | 31.7 | NR | 12 | Outpatient clinic |
Acosta-Olivo (2017) [21] | Corticosteroid injection | Platelet-rich plasma injection | Plantar fascia stretches | 14 | 14 | 80 | 44.8 | NR | > 12 weeks | 16 | Outpatient clinic |
Afsar (2015) [22] | Corticosteroid injection | Autologous blood injection | None | 62 | 61 | 57 | 31.8 | NR | > 12 weeks | 24 | Outpatient clinic |
Babaei-Ghazani (2019) [23] | Corticosteroid injection | Ozone injection | Plantar fascia and calf stretches | 15 | 15 | 90 | 46.3 | 29.0 | > 8 weeks | 12 | Outpatient clinic |
Ball (2012) [24] | Corticosteroid injection | Placebo injection | Permitted to use analgesia if required | 22 | 19 | 56 | 49.4 | 31.6 | > 8 weeks | 12 | Rheumatology service |
Celik (2015) [25] | Corticosteroid injection | Physical therapy | None | 21 | 22 | 65 | 45.5 | 30.0 | NR | 52 | Hospital |
Crawford (1999) [26] | Corticosteroid injection | Local anaesthetic injection | NR | 27 | 27 | 65 | 57.0 | NR | NR | 26 | Hospital |
Corticosteroid injection + tibial nerve block | Local anaesthetic injection + tibial nerve block | 26 | 26 | ||||||||
Diaz-Llopis (2012) [27] | Corticosteroid injection | Botulinum toxin-A injection | Plantar fascia and calf stretches | 28 | 28 | 66 | 53.9 | NR | > 26 weeks | 4 | Hospital |
Elizondo-Rodriguez (2013) [28] | Corticosteroid injection | Botulinum toxin-A injection | Plantar fascia stretches | 17 | 17 | 55 | 43.0 | NR | > 12 weeks | 26 | Hospital |
Eslamian (2016) [29] | Corticosteroid injection | Extracorporeal shockwave therapy | i) Foot orthoses and heel pads; ii) plantar fascia and calf stretches | 20 | 20 | 82 | 42.1 | NR | > 8 weeks | 8 | Hospital |
Guevara Serna (2017) [30] | Corticosteroid injection | Extracorporeal shockwave therapy | NR | 24 | 36 | 67 | 51.0 | NR | > 12 weeks | 52 | Hospital |
Guner (2013) [31] | Corticosteroid injection | Tenoxicam injection | A stretching and strengthening program | 30 | 31 | 77 | 41.4 | 29.5 | > 12 weeks | 52 | NR |
Hanselman (2015) [32] | Corticosteroid injection | Cryopreserved human amniotic membrane | Plantar fascia and calf stretches | 14 | 9 | 70 | 51.0 | NR | > 12 weeks | 18 | NR |
Hocaoglu (2017) [33] | Corticosteroid injection | Extracorporeal shockwave therapy | NR | 36 | 36 | 87 | 49.0 | 28.7 | > 26 weeks | 26 | Outpatient clinic |
Hou (2018) [34] | Corticosteroid injection | Extracorporeal shockwave therapy | NR | 39 | 38 | 35 | 41.5 | 25.4 | > 12 weeks | 26 | Hospital |
Jain (2015) [35] | Corticosteroid injection | Platelet-rich plasma injection | i) Eccentric stretches; ii) foot orthoses | 22 | 24 | 65 | 55.6 | NR | > 52 weeks | 52 | Hospital |
Jain (2018) [36] | Corticosteroid injection | Platelet-rich plasma injection | Plantar fascia and calf stretches | 40 | 40 | 42 | 38.3 | 24.1 | > 12 weeks | 26 | Hospital |
Johannsen (2019) [37] | Corticosteroid injection | Physical therapy | NR | 31 | 30 | 58 | 45.0 | 26.2 | > 12 weeks | 104 | University |
Corticosteroid injection + physical therapy | 29 | ||||||||||
Karimzadeh (2017) [38] | Corticosteroid injection | Control group | Plantar fascia stretches | 12 | 12 | 67 | 47.5 | NR | > 8 weeks | 12 | NR |
Autologous blood injection | 12 | ||||||||||
Kiter (2006) [39] | Corticosteroid injection | Autologous blood injection | NR | 14 | 15 | 69 | 50.7 | NR | > 26 weeks | 26 | University |
Kriss (2003) [40] | Corticosteroid injection | Foot orthoses | NR | 22 | 26 | 60 | 59.3 | NR | NR | 26 | NR |
Corticosteroid injection + foot orthoses | 31 | ||||||||||
Lai (2018) [41] | Corticosteroid injection | Extracorporeal shockwave therapy | Acetaminophen as required | 50 | 47 | 56 | 53.5 | NR | > 4 weeks | 12 | Hospital |
Lee (2007) [42] | Corticosteroid injection | Autologous blood injection | Plantar fascia and calf stretches | 31 | 30 | 93 | 48.7 | 26.1 | > 6 weeks | 26 | Outpatient clinic |
Li (2014) [43] | Corticosteroid injection | Miniscalpel needle | Participants were permitted to continue with any conservative treatment | 30 | 31 | 72 | 55.8 | NR | > 26 weeks | 52 | Hospital |
Mahindra (2016) [44] | Corticosteroid injection | Placebo injection | Plantar fascia and calf stretches | 25 | 25 | 58 | 33.4 | NR | > 12 weeks | 12 | NR |
Platelet-rich plasma injection | 25 | ||||||||||
Mardani-Kivi (2015) [45] | Corticosteroid injection | Extracorporeal shockwave therapy | None | 41 | 40 | 84 | 44.3 | 29.6 | < 6 weeks | 12 | University |
McMillan (2012) [46] | Corticosteroid injection | Placebo injection | Plantar fascia stretches | 41 | 41 | 48 | 52.6 | 31.1 | > 8 weeks | 12 | University |
Monto (2014) [47] | Corticosteroid injection | Platelet-rich plasma injection | i) CAM walker for two weeks; ii) Swedish heel drop program; iii) plantar fascia and calf stretches | 20 | 20 | 57 | 55.0 | 29.2 | > 16 weeks | 104 | NR |
Mulherin (2009) [48] | Corticosteroid injection | Tibial nerve block | 14 | 12 | 60 | 55 (median) | NR | NR | 26 | Community medical centre | |
Corticosteroid injection + tibial nerve block | 19 | ||||||||||
Omar (2012) [49] | Corticosteroid injection | Platelet-rich plasma injection | NR | 15 | 15 | 100 | 43.5 | NR | NR | 6 | Hospital |
Porter (2005) [50] | Corticosteroid injection | Extracorporeal shockwave therapy | Plantar fascia and calf stretches | 64 | 61 | 66 | 39.2 | NR | > 6 weeks | 52 | Hospital |
Rastegar (2018) [51] | Corticosteroid injection | Dry-needling | NR | 34 | 32 | 58 | 40.9 | NR | > 12 weeks | 52 | University |
Ryan (2014) [52] | Corticosteroid injection | Physical therapy | Calf stretches | 28 | 28 | 57 | 49.3 | 25.2 | > 52 weeks | 12 | University |
Saber (2012) [53] | Corticosteroid injection | Extracorporeal shockwave therapy | NR | 30 | 30 | 55 | 34.2 | 29.0 | > 26 weeks | 12 | Outpatient clinic |
Serbest (2013) [54] | Corticosteroid injection | Extracorporeal shockwave therapy | NR | 15 | 15 | 53 | 45.2 | 30.5 | > 6 weeks | 12 | Sports medicine clinic |
Shetty (2019) [55] | Corticosteroid injection | Placebo injection | i) Oral enterocoxib and paracetamol for 5 days; ii) plantar fascia stretches; iii) eccentric calf strengthening | 30 | 30 | 54 | 44.6 | NR | > 12 weeks | 78 | Hospital |
Platelet-rich plasma injection | 30 | ||||||||||
Sorrentino (2008) [56] | Corticosteroid injection in participants with perifascial oedema | Extracorporeal shockwave therapy | NR | 16 | 15 | 56 | NR | 27.9 | > 8 weeks | 6 | University |
Corticosteroid injection in participants without perifascial oedema | Extracorporeal shockwave therapy | 15 | 16 | ||||||||
Tiwari (2013) [57] | Corticosteroid injection | Platelet-rich plasma injection | NR | 30 | 30 | NR | NR | NR | NR | 26 | Hospital |
Ugurlar (2018) [58] | Corticosteroid injection | Platelet-rich plasma injection | Acetaminophen for 3 days | 40 | 39 | 50 | 38.8 | 26.9 | > 52 weeks | 156 | Hospital |
Extracorporeal shockwave therapy | Prolotherapy | 39 | 40 | ||||||||
Uygur (2018) [59] | Corticosteroid injection | Dry-needling | NR | 47 | 49 | 66 | 49.6 | NR | > 12 weeks | 26 | Hospital |
Vahdatpour (2016) [60] | Corticosteroid injection | Platelet-rich plasma injection | Plantar fascia and calf stretches | 16 | 16 | 72 | 46.2 | 29.6 | > 12 weeks | 26 | Hospital |
Whittaker (2019) [61] | Corticosteroid injection | Foot orthoses | Plantar fascia and calf stretches | 50 | 53 | 61 | 43.9 | 30.4 | > 4 weeks | 12 | University |
Yesiltas (2015) [62] | Corticosteroid injection | Autologous blood injection | NR | 21 | 28 | 57 | 45.5 | 30.4 | NR | 26 | Hospital |
Yucel (2010) [63] | Corticosteroid injection | Extracorporeal shockwave therapy | None permitted other than heel cups | 33 | 27 | 70 | 43.9 | NR | > 26 weeks | 12 | NR |
Yucel (2013) [64] | Corticosteroid injection | Foot orthoses | Analgesia if required | 20 | 20 | 80 | 46.4 | 30.1 | > 12 weeks | 4 | University |
Yuzer (2006) [65] | Corticosteroid injection | Laser therapy | NR | 30 | 24 | 85 | 50.5 | 32.3 | > 4 weeks | 26 | NR |
Zamani (2014) [66] | Corticosteroid injection | Laser therapy | NR | 20 | 20 | 57 | 52.5 | NR | > 6 weeks | 6 | Rheumatology clinic |
Trial | Drug | Local anaesthetic | Ultrasound guidance | Needle placement |
---|---|---|---|---|
Abdihakin (2012) [20] | Methylprednisolone acetate | Lidocaine 1% | No | NR |
Acosta-Olivo (2017) [21] | Dexamethasone isonicotinate | Lidocainea | No | Point of maximal tenderness |
Afsar (2015) [22] | NR | Lidocaine 1% | No | NR |
Babaei-Ghazani (2019) [23] | Methylprednisolone acetate | Lidocaine 1% | Yes | Within the plantar fascia |
Ball (2012) [24] | Methylprednisolone acetate | None. Skin anesthetized | Yes | Superficial to the plantar fascia enthesis |
Celik (2015) [25] | Methylprednisolone acetate | Prilocaine 2% | No | Around the plantar fascia |
Crawford (1999) [26] | Prednisolone acetate | Lidocaine 1% | No | Within flexor digitorum brevis |
Diaz-Llopis (2012) [27] | Betamethasone acetate and betamethasone disodium phosphate | Mepivacaine 1% | No | Deep to quadratus plantae, near the plantar fascia insertion |
Elizondo-Rodriguez (2013) [28] | Dexamethasone isonicotinate | Lidocaine 2% | No | Superior to the plantar fascia |
Eslamian (2016) [29] | Methylprednisolone acetate | Lidocaine 2% | No | NR |
Guevara Serna (2017) [30] | Methylprednisolone acetate | Lidocainea | No | Point of maximal tenderness |
Guner (2013) [31] | Methylprednisolone acetate | Lidocaine 2% | No | Peppering the plantar fascia |
Hanselman (2015) [32] | Methylprednisolone acetate | Bupivacaine 0.5% | No | Inserted to calcaneal periosteum then ‘dragged’ across plantar fascia |
Hocaoglu (2017) [33] | Betamethasone sodium phosphate | Prilocainea | Yes | Into the thickest part of the plantar fascia, distal to its insertion on the calcaneus |
Huo (2018) [34] | Betamethasonea | Lidocaine 2% | Yes | Within the thickest part of the plantar fascia |
Jain (2015) [35] | Triamcinolone acetonide | Levobupivacainea | No | Peppering the plantar fascia |
Jain (2018) [36] | Methylprednisolone acetate | Lidocaine 2% | No | Point of maximal tenderness |
Johannsen (2019) [37] | Methylprednisolone acetate | Lidocaine 1% | Yes | NR |
Karimzadeh (2017) [38] | Methylprednisolone acetate | Lidocainea | No | Point of maximal tenderness |
Kiter (2006) [39] | Methylprednisolone acetate | Prilocaine 2% | No | NR |
Kriss (2003) [40] | Triamcinolone hexacetonide | NR | No | NR |
Lai (2018) [41] | Triamcinolone acetonide | Lidocaine 2% | No | NR |
Lee (2007) [42] | Triamcinolone acetonide | Lidocaine 1% | No | Origin of the plantar fascia |
Li (2014) [43] | Triamcinolone acetonide | Lidocaine 2% | No | Point of maximal tenderness |
Mahindra (2016) [44] | Methylprednisolone acetate | NR | No | Peppering the plantar fascia |
Mardani-Kivi (2015) [45] | Methylprednisolone acetate | Lidocaine 2% | No | Point of maximal tenderness |
McMillan (2012) [46] | Dexamethasone sodium phosphate | Nil – provided tibial block | Yes | Within the plantar fascia |
Monto (2014) [47] | Methylprednisolone acetate | Field block to the skin of bupivacaine 0.5% | Yes | NR |
Mulherin (2009) [48] | Methylprednisolonea | Lidocaine 1% | No | Within the plantar fascia |
Omar (2012) [49] | NR | NR | No | NR |
Porter (2005) [50] | Betamethasonea | Lidocaine 1% | No | Point of maximal tenderness |
Rastegar (2018) [51] | Methylprednisolone acetate | NR | No | Point of maximal tenderness |
Ryan (2014) [52] | Dexamethasonea | Lidocaine 1% | No | Point of maximal tenderness |
Saber (2012) [53] | Betamethasone diproprionate and betamethasone sodium phosphate | Lidocaine 0.5% | Yes | Within the plantar fascia |
Serbest (2013) [54] | Betamethasone acetate and betamethasone sodium phosphate | Prilocaine 2% | No | Point of maximal tenderness |
Shetty (2019) [55] | Methylprednisolone acetate | Lidocaine 1% | No | Peppering the point of maximal tenderness |
Sorrentino (2008) [56] | Methylprednisolone acetate | Mepivacaine 3% | Yes | Within the plantar fascia |
Tiwari (2013) [57] | Methylprednisolone acetate | Lidocaine 2% | No | Point of maximal tenderness |
Ugurlar (2018) [58] | Betamethasonea | Bupivacaine 0.5% | Yes | Point of maximal tenderness |
Uygur (2018) [59] | Methylprednisolone acetate | Bupivacaine 0.5% | No | Between the plantar fascia and the periosteum, with peppering |
Vahdatpour (2016) [60] | Methylprednisolone acetate | Lidocainea | No | Point of maximal tenderness |
Whittaker (2019) [61] | Betamethasone acetate and betamethasone sodium phosphate | Bupivacaine 0.5% | Yes | Deep and superficial to the plantar fascia |
Yesiltas (2015) [62] | Triamcinolonea (mixed with distilled water) | NR | No | NR |
Yucel (2010) [63] | Betamethasone diproprionate and betamethasone sodium phosphate | Prilocaine 2% | No | Point of maximal tenderness |
Yucel (2013) [64] | Betamethasone diproprionate and betamethasone sodium phosphate | Lidocainea | Yes | Within the plantar fascia |
Yuzer (2006) [65] | Betamethasone diproprionate and betamethasone sodium phosphate | Prilocaine 2% | No | Point of maximal tenderness |
Zamani (2014) [66] | Methylprednisolone acetate | NR | No | Point of maximal tenderness |
Quality assessment | Summary of findings | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Comparison | No. of trials | Limitations | Inconsistency | Indirectness | Imprecision | Publication bias | Participants | Effect size (95% CI)a | GRADE | |
Corticosteroid injection | Comparator | |||||||||
Corticosteroid injection vs placebo injection | ||||||||||
Short term | No serious limitations | Serious inconsistencyb | No serious indirectness | Serious imprecisionc | Undetected | 132 | 123 | -0.98 (−2.06, 0.11)f | Moderate | |
Medium term | No serious limitations | Serious inconsistencyb | No serious indirectness | Serious imprecisionc | Undetected | 126 | 122 | -0.86 (− 1.90, 0.19)f | Moderate | |
Corticosteroid injection vs physical therapy | ||||||||||
Short term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | Serious imprecisione | Undetected | 49 | 50 | -1.07 (−2.75, 0.60)f | Very low | |
Medium term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | No serious imprecision | Undetected | 80 | 79 | -0.74 (− 1.51, 0.03)f | Low | |
Longer term | Very serious limitationsd | No serious inconsistency | No serious indirectness | Serious imprecisionc | Undetected | 52 | 51 | 0.00 (−0.39, 0.38) | Very low | |
Corticosteroid injection vs foot orthoses | ||||||||||
Short term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | No serious imprecision | Undetected | 92 | 99 | −0.91 (−1.69, − 0.13)f | Low | |
Medium term | Very serious limitationsd | Serious inconsistencyb | Serious indirectnessg | Serious imprecisionc | Undetected | 72 | 79 | −0.17 (− 1.30, 0.97) | Very low | |
Corticosteroid injection vs dry needling | ||||||||||
Short term | Very serious limitationsd | Very serious inconsistencyb | No serious indirectness | Serious imprecisionc | Undetected | 81 | 81 | −0.86 (−3.70, 1.97)f | Very low | |
Longer term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | No serious imprecision | Undetected | 81 | 81 | 1.45 (0.70, 2.19)f | Low | |
Corticosteroid injection vs extracorporeal shockwave therapy | ||||||||||
Short term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | No serious imprecision | Undetected | 269 | 265 | −0.32 (−0.77, 0.12) | Very low | |
Medium term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | Serious imprecisionc | Undetected | 354 | 354 | −0.05 (−0.60, 0.49) | Very low | |
Longer term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | No serious imprecision | Undetected | 202 | 211 | 0.45 (−0.09, 0.99) | Very low | |
Corticosteroid injection vs laser therapy | ||||||||||
Short term | Very serious limitationsd | No serious inconsistency | Serious indirectnessg | Serious imprecisionc | Undetected | 50 | 44 | −0.20 (−0.61, 0.20) | Very low | |
Corticosteroid injection vs autologous blood injection | ||||||||||
Short term | Very serious limitationsd | No serious inconsistency | No serious indirectness | No serious imprecision | Undetected | 126 | 131 | −0.56 (−0.86, − 0.26) | Low | |
Medium term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | Serious imprecisionc | Undetected | 126 | 131 | −0.31 (−0.83, 0.21) | Very low | |
Longer term | Very serious limitationsd | No serious inconsistency | No serious indirectness | Serious imprecisionc | Undetected | 128 | 134 | −0.05 (−0.31, 0.21) | Very low | |
Corticosteroid injection vs platelet-rich plasma injection | ||||||||||
Short term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | Serious imprecisionc | Undetected | 202 | 203 | −0.16 (−0.70, 0.38) | Very low | |
Medium term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | Serious imprecisionc | Undetected | 187 | 188 | 0.32 (−0.19, 0.83) | Very low | |
Longer term | Very serious limitationsd | Serious inconsistencyb | Serious indirectnessh | No serious imprecision | Undetected | 162 | 163 | 0.61 (0.30, 1.06) | Very low | |
Corticosteroid injection vs botulinum toxin-A injection | ||||||||||
Short term | Very serious limitationsd | Serious inconsistencyb | No serious indirectness | Serious imprecisione | Undetected | 45 | 45 | 0.67 (−0.04, 1.38) | Very low |
Quality assessment | Summary of findings | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Comparison | No. of trials | Limitations | Inconsistency | Indirectness | Imprecision | Publication bias | Participants | Effect size (95% CI)a | GRADE | |
Corticosteroid injection | Comparator | |||||||||
Corticosteroid injection vs physical therapy | ||||||||||
Short term | Very serious limitationsb | Serious inconsistencyc | No serious indirectness | No serious imprecision | Undetected | 49 | 50 | −0.69 (−1.31, − 0.07) | Low | |
Medium term | Very serious limitationsb | Serious inconsistencyc | No serious indirectness | Serious imprecisiond | Undetected | 49 | 50 | −0.55 (− 1.14, 0.03) | Very low | |
Corticosteroid injection vs foot orthoses | ||||||||||
Short term | Very serious limitationsb | Serious inconsistencyc | No serious indirectness | Serious imprecisiond | Undetected | 70 | 73 | −0.78 (−1.81, 0.25) | Very low | |
Corticosteroid injection vs extracorporeal shockwave therapy | ||||||||||
Short term | Very serious limitationsb | No serious inconsistency | No serious indirectness | Serious imprecisiond | Undetected | 90 | 86 | 0.11 (−0.18, 0.41) | Very low | |
Medium term | Very serious limitationsb | No serious inconsistency | No serious indirectness | Serious imprecisiond | Undetected | 90 | 86 | 0.21 (−0.08, 0.51) | Very low | |
Corticosteroid injection vs platelet-rich plasma injection | ||||||||||
Short term | Very serious limitationsb | No serious inconsistency | No serious indirectness | No serious imprecision | Undetected | 94 | 93 | −0.18 (−0.47, 0.10) | Low | |
Medium term | Very serious limitationsb | No serious inconsistency | No serious indirectness | Serious imprecisiond | Undetected | 94 | 93 | 0.10(−0.18, 0.39) | Very low | |
Longer term | Very serious limitationsb | No serious inconsistency | No serious indirectness | No serious imprecision | Undetected | 94 | 93 | 0.21 (−0.08, 0.49) | Low | |
Corticosteroid injection vs botulinum toxin-A injection | ||||||||||
Short term | Very serious limitationsb | Serious inconsistencyc | No serious indirectness | Serious imprecisiond | Undetected | 45 | 45 | 0.76 (−0.24, 1.76) | Very low |