PRP in podiatry: treatment of heel spurs and foot pain

PRP in podiatry: treatment of heel spurs and foot pain

Introduction: What is PRP?

The abbreviation PRP stands for " platelet-rich plasma". This innovative therapy has become increasingly important in recent years, particularly in podiatry, i.e. medical foot care. PRP is obtained from the patient's own blood and is rich in growth factors that stimulate natural healing processes in the body. In podiatry, PRP is often used to treat heel spurs and chronic foot pain. But how exactly does this therapy work and what do the latest studies say about it?

What is a heel spur and why does it develop?

Heel spurs are one of the most common causes of chronic foot pain. It is a bony protrusion on the heel caused by overloading the plantar tendon (plantar fascia). This overloading leads to micro-injuries that can become inflamed over time. The risk factors include

  • Obesity
  • Prolonged standing or walking
  • Incorrect footwear
  • Flat feet or an unfavorable foot position

The pain caused by the heel spur is often most severe when it first occurs after standing up or after long periods of rest.

How does PRP work in the treatment of heel spurs?

PRP therapy utilizes the body's natural healing mechanisms by injecting concentrated platelets and growth factors directly into the affected tissue. These growth factors stimulate the regeneration of connective tissue, reduce inflammation and promote blood circulation.

A typical PRP treatment procedure is as follows:

  1. Blood collection: a small amount of blood is taken from the patient.
  2. Centrifugation: The blood is processed in a centrifuge to separate the platelets from the rest of the blood.
  3. Injection: The platelet-rich plasma is then injected into the damaged tissue of the heel.

The entire procedure usually takes less than an hour and does not require surgery. Patients can resume their daily routine immediately after the treatment.

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What advantages does PRP offer over traditional treatments?

Traditional treatments for heel spurs often include painkillers, physiotherapy, special insoles and, in severe cases, corticosteroid injections. While these approaches can provide short-term relief, they often have side effects or do not lead to a permanent cure.

PRP offers several advantages over these conventional methods:

  • Long-term pain relief: studies show that PRP can provide better long-term pain relief compared to steroid injections.
  • No serious side effects: As PRP is obtained from the patient's own blood, there is no risk of allergic reactions or infections.
  • Promotes regeneration: In contrast to steroid injections, which only inhibit inflammation, PRP supports the actual healing of the tissue.

What do the latest studies say about PRP therapy for heel spurs?

In recent years, numerous studies have been conducted to evaluate the effectiveness of PRP in the treatment of heel spurs and foot pain. A systematic review and meta-analysis from 2021, published in the renowned journal Orthopaedics & Traumatology: Surgery & Research, concluded that PRP provides clinically better results than conventional steroid injections in the medium-term treatment of heel spurs. In particular, there was a significant improvement in pain scores (as measured by the VAS scale) and foot function (as assessed by the AOFAS scale) in patients treated with PRP.

Another study, published in the Indian Journal of Orthopaedics, examined the effect of PRP on plantar fascia thickness. The researchers found that PRP not only reduced pain, but also led to a significant reduction in plantar fascia thickness, which is an indication of actual healing of the tissue.

PRP-Therapy Laboratory

Which patients benefit most from PRP?

PRP therapy is particularly suitable for patients for whom conservative treatment methods such as physiotherapy, special insoles or medication have not helped sufficiently. However, there are some contraindications that should be taken into account. Patients with severe systemic diseases, active infections or a blood clotting disorder may not be suitable candidates for PRP.

How many PRP sessions are necessary?

The number of PRP sessions may vary depending on the severity of the disease and the individual healing process. Generally, a single injection is administered, followed by a follow-up after a few weeks. However, some patients require a second or third injection to achieve optimal results.

Studies have shown that most patients experience significant pain relief within 6 to 12 weeks of the first injection. In more severe cases, a longer treatment period may be required.

Side effects and risks of PRP therapy

As PRP is obtained from the patient's own blood, the risk of side effects is very low. The most common side effects include slight pain or swelling at the injection site, but these usually subside within a few days.

Compared to steroid injections, which can be associated with an increased risk of tendon rupture or infection, PRP is a far safer option.

Conclusion: PRP - a promising option for the treatment of heel spurs

PRP therapy is increasingly becoming a promising and effective treatment method in podiatry for heel spurs and chronic foot pain. The latest studies prove the effectiveness of this therapy, especially in comparison to traditional steroid injections. PRP not only provides long-term pain relief, but also supports the actual regeneration of the damaged tissue.

For patients suffering from chronic foot pain where conservative treatments have failed, PRP can be a worthwhile alternative. Speak to a specialist podiatrist or orthopaedic surgeon to find out if PRP is right for you.

Sources and further information

  • Role of Platelet Rich Plasma in Chronic Plantar Fasciitis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8149543/

  • Platelet-rich plasma has better mid-term clinical results than traditional steroid injection for plantar fasciitis: A systematic review and meta-analysis

https://www.sciencedirect.com

  • Insight on Platelet-rich Plasma and Applications for Heel Pain

https://www.hmpgloballearningnetwork.com

  • Comparative study of local injections of autologous platelet rich plasma versus corticosteroid in management of chronic plantar fasciitis

https://pubmed.ncbi.nlm.nih.gov/37520269/

  • Therapeutic efficacy of platelet-rich plasma injection compared to corticosteroid injection in plantar fasciitis: A systematic review and meta-analysis

https://pubmed.ncbi.nlm.nih.gov/32336895/

  • Platelet-Rich Plasma Has Better Long-Term Results Than Corticosteroids or Placebo for Chronic Plantar Fasciitis: Randomized Control Trial

https://pubmed.ncbi.nlm.nih.gov/30448183/

  • Platelet-rich plasma or extracorporeal shockwave therapy for plantar fasciitis

https://pubmed.ncbi.nlm.nih.gov/33824779/

  • Efficacy and Safety of Platelet-Rich Plasma Injection for Chronic Plantar Fasciitis: A Prospective Study on Functional Restoration and Pain Relief

https://pubmed.ncbi.nlm.nih.gov/38371014/

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