KGMU study offers new relief options for chronic heel pain
The study, 'Ultrasonography-guided dextrose prolotherapy versus platelet-rich plasma injections for the treatment of Plantar Fasciitis', was published in the journal Cureus in Feb. Researchers from KGMU's physical medicine and rehabilitation (PMR) department found two regenerative methods — dextrose prolotherapy and platelet-rich plasma (PRP) injections.
Lead researcher Prof Sudhir Mishra said that chronic heel pain is due to damage to the thick tissue under the foot and often difficult to treat with conventional methods.
This affects about 10% of people, especially women in 40-60 age group and athletes. Traditional treatments like rest, stretching, orthotics, corticosteroids and physical therapy often help, but many patients still experience pain.
The study involved 44 patients unresponsive to standard treatments. They were split into two groups — one received ultrasound-guided 25% dextrose injections, the other PRP from their own blood.
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After six weeks, both groups reported less pain and improved foot and ankle function. PRP showed slightly better results, but differences were not always significant.
Prof Mishra said these minimally invasive injections are well tolerated and can greatly improve the quality of life for patients who do not respond to conventional treatments. Although PRP is more costly and complex to prepare, both treatments are safe, effective and can be chosen based on patient needs.
The study supports growing evidence for regenerative medicine in chronic musculoskeletal pain.
Physical medicine and rehabilitation department head, Prof Anil Kumar Gupta, said treatment usually starts with rest, special insoles and sometimes steroid injections, which work well in early or mild cases. When traditional methods fail, regenerative therapies like dextrose prolotherapy and PRP are considered.
Both stimulate tissue repair — dextrose needs multiple injections and lasts shorter, while PRP often requires a single injection and lasts longer.
Prof Mishra said dextrose costs about Rs 500-700 per session, including ultrasound guidance, making it more affordable. PRP costs Rs 3,000-3,500 due to specialised processing but requires fewer sessions. PRP is especially effective for long-term pain lasting months or more.
Using the patient's own blood lowers allergy risks and can work when other treatments fail.
Choice depends on pain duration and severity. For pain lasting a week or two, traditional methods suffice. For pain over a month, dextrose prolotherapy may be advised. For pain lasting three months or more, especially if other treatments fail, PRP is preferred. Dextrose typically requires 2-3 injections spaced 15 days apart, while PRP usually needs one injection, with a second dose for severe cases. Both are effective, but PRP tends to offer better pain relief and longer recovery.
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