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BMC Musculoskeletal Disorders

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Open Access 01-12-2019 | Shockwave Therapy | Research article

Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis

Authors: Glen A. Whittaker, Shannon E. Munteanu, Hylton B. Menz, Daniel R. Bonanno, James M. Gerrard, Karl B. Landorf

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Abstract

Background

Corticosteroid injection is frequently used for plantar heel pain (plantar fasciitis), although there is limited high-quality evidence to support this treatment. Therefore, this study reviewed randomised trials to estimate the effectiveness of corticosteroid injection for plantar heel pain.

Methods

A systematic review and meta-analysis of randomised trials that compared corticosteroid injection to any comparator. Primary outcomes were pain and function, categorised as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks).

Results

A total of 47 trials (2989 participants) were included. For reducing pain in the short term, corticosteroid injection was more effective than autologous blood injection (SMD -0.56; 95% CI, − 0.86 to − 0.26) and foot orthoses (SMD -0.91; 95% CI, − 1.69 to − 0.13). There were no significant findings in the medium term. In the longer term, corticosteroid injection was less effective than dry needling (SMD 1.45; 95% CI, 0.70 to 2.19) and platelet-rich plasma injection (SMD 0.61; 95% CI, 0.16 to 1.06). Notably, corticosteroid injection was found to have similar effectiveness to placebo injection for reducing pain in the short (SMD -0.98; 95% CI, − 2.06, 0.11) and medium terms (SMD -0.86; 95% CI, − 1.90 to 0.19). For improving function, corticosteroid injection was more effective than physical therapy in the short term (SMD -0.69; 95% CI, − 1.31 to − 0.07). When trials considered to have high risk of bias were excluded, there were no significant findings.

Conclusions

Based on the findings of this review, corticosteroid injection is more effective than some comparators for the reduction of pain and the improvement of function in people with plantar heel pain. However, corticosteroid injection is not more effective than placebo injection for reducing pain or improving function. Further trials that are of low risk of bias will strengthen this evidence.

Registration

PROSPERO registration number CRD42016053216.

Available only for authorised users

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Title: Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis
Authors: Glen A. Whittaker
Shannon E. Munteanu
Hylton B. Menz
Daniel R. Bonanno
James M. Gerrard
Karl B. Landorf
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Shockwave Therapy
Physical Therapy
Plantar Fasciitis
Published in: BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-019-2749-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Registration

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