Shockwave, PRP, and Steroid for Plantar Fasciitis: What the Evidence Says

First, who are these for?

These procedures are considered for persistent plantar fasciitis - heel pain that has not improved enough after several months of consistent conservative care (load management, stretching, footwear, and strengthening). They are not first steps, and they work best alongside, not instead of, the foundations. The plantar fascia = the thick band of tissue along the sole of your foot, and none of these options replaces the gradual healing that good self-care supports.

Shockwave therapy (ESWT)

How it works: Extracorporeal shockwave therapy delivers focused sound-wave pulses to the heel, which are thought to stimulate blood flow and a healing response in the irritated tissue. It is non-invasive and usually done over several sessions.

What the evidence says: Shockwave is one of the better-studied options for chronic plantar fasciitis, and reviews generally support a modest benefit for pain and function in people who have not responded to first-line care. Results build over weeks rather than immediately.

Practical notes: Sessions can be mildly uncomfortable, and it is common to feel some soreness afterward. Because it is non-invasive, it is often tried before injections.

Steroid (corticosteroid) injection

How it works: A corticosteroid is injected near the fascia to reduce pain and local irritation.

What the evidence says: Steroid injections can provide short-term pain relief for some people, but the benefit often fades over weeks to a few months, and studies do not show a reliable long-term advantage. There are also limits: repeated steroid injections carry a possible risk of thinning the heel fat pad or, rarely, contributing to a fascia rupture, so their number is kept low.

Practical notes: A steroid injection may be useful to settle a severe flare enough to let you resume rehabilitation - it is a bridge, not a standalone fix.

PRP (platelet-rich plasma) injection

How it works: A small sample of your own blood is spun down to concentrate platelets, then injected near the fascia with the aim of encouraging healing.

What the evidence says: The evidence for PRP in plantar fasciitis is mixed. Some studies suggest it may help over the longer term compared with steroid, while others show little difference, and preparation methods vary between clinics, which makes results hard to compare. Because of this, PRP is discussed case by case and never promised as a solution.

Practical notes: As it uses your own blood, tolerance is generally good, though some soreness after injection is common.

Comparing them at a glance

• Least invasive: Shockwave (no needle into the fascia).
• Fastest short-term pain relief: Steroid, though it may be temporary and is limited in how often it can be repeated.
• Aim of longer-term healing, mixed evidence: PRP.
• Best supported for chronic cases overall: Shockwave has the most consistent evidence base, but "best fit" still depends on the individual.

How our team approaches it

Our pain medicine team performs injections under image guidance so they are placed accurately, using internationally accredited techniques and equipment, with same-day discharge. We choose based on how long you have had symptoms, what you have already tried, your goals, and an assessment of your foot - and we are upfront about what each option can and cannot do. In many cases we combine a procedure with continued rehabilitation, because the exercises remain part of recovery. For where these sit in the overall plan, see our treatment options article; for image-guided and advanced choices, see our advanced options article.

Talk to our team

If heel pain is not improving, our medical team can assess the cause and options. Contact us on LINE (@younifyclinic) or WhatsApp +66 81 556 9696.

YOUNIFY Clinic - 2nd Floor, Room 214, United Center Building, 323 Silom Road, Silom, Bang Rak, Bangkok 10500. Open daily 11:00–20:00.