For plantar fasciitis that has lasted more than 3 months, PRP gives better pain and function than a steroid injection at 3 and 6 months across 24 randomised trials, with no difference at 1 month or 12 months. Steroid works faster and fades. Neither replaces stretching, load management and footwear, and not all heel pain is plantar fasciitis.
Key points
A 2025 meta-analysis in the American Journal of Physical Medicine and Rehabilitation of 24 randomised trials and 1,653 participants found PRP gave significantly better pain scores than corticosteroid at 3 and 6months, with no significant difference at 1 month or 12 months, and better American Orthopaedic Footand Ankle Society scores at 3 and 6 months.
A 2017 meta-analysis of 9 randomised trials and 430 patients found no difference between PRP and corticosteroid at 4 and 12 weeks, and PRP more effective at 24 weeks.
A Cochrane review found no long-term benefit of corticosteroid injection over placebo at 6 months, and repeated steroid injections into the plantar fascia carry a recognised risk of rupture and fat pad thinning.
A 2023 randomised trial in BMC Musculoskeletal Disorders found PRP reduced plantar fascia thickness on ultrasound from 4.58 to 3.53 mm at 6 months compared with steroid, alongside better pain and function scores.
If you have heel pain that has not settled with stretching and rest, message us on WhatsApp or email team@thewellnesslondon.com and a doctor will look at your history before recommending anything.
What plantar fasciitis actually is, and why the name misleads
The plantar fascia is a thick band running from the heel bone to the toes that supports the arch. Plantarfasciitis is pain where it attaches to the heel, classically worst with the first steps in the morning or after sitting,easing with movement and returning after long standing. The suffix suggests inflammation, but biopsy and imaging studies show a degenerative process in the fascia, thickening and disorganisation rather than acute inflammation, which is why many clinicians now call it plantar fasciosis.
That distinction explains the injection evidence. An anti-inflammatory steroid gives fast relief because itnumbs a sensitised attachment, and then the relief fades because the underlying degeneration is unchanged.A treatment that aims to change the tissue takes longer and, where it works, lasts longer. Risk factors are weight, reduced ankle flexibility, prolonged standing on hard floors, and a sudden increase in walking or running load. Most cases settle within 12 months with conservative treatment alone, which is the context for every injection decision that follows.
message us on WhatsApp or email team@thewellnesslondon.com
What the trials show against steroid
The largest synthesis is the 2025 meta-analysis in the American Journal of Physical Medicine and Rehabilitation, which pooled 24 randomised trials and 1,653 participants comparing PRP with corticosteroid injection. On pain, PRP was significantly better at 3 months and at 6 months, with no significant difference at 1month or at 12 months. On the American Orthopaedic Foot and Ankle Society function score, PRP wassuperior at 3 and 6 months. The authors concluded PRP offers better pain control in the medium term but not the short term or at 1 year.
That pattern is consistent across the literature. A 2017 meta-analysis of 9 randomised trials and 430 patients found no difference at 4 and 12 weeks and a PRP advantage at 24 weeks. A 2020 meta-analysis of 21randomised trials and 1,356 patients found lower pain scores with PRP at 6 and 12 months and no difference at 1 and 3 months. A 2023 randomised trial in BMC Musculoskeletal Disorders found PRP gave better pain and function at 6 months and reduced fascia thickness on ultrasound from 4.58 to 3.53 mm, a structural change steroid did not produce.
The honest limit is the 12-month picture. In the largest analysis the two treatments were level at a year, which fits a condition that mostly settles on its own. PRP appears to shorten the middle of that year rather than change its end.
Send us your heel pain history on WhatsApp and a doctor will tell you whether your timeline matches the patients who benefited.
Why a steroid injection is not the easy answer
A steroid injection into the heel is cheap, fast and widely available on the NHS, and for a patient who needs toget through the next 6 weeks it is reasonable. The evidence against it is longer term. A Cochrane review found no benefit of corticosteroid over placebo at 6 months. Steroid also carries structural risks specific to this site.Repeated injections into the plantar fascia are associated with rupture of the fascia and thinning of the heel fatpad, both of which cause a different and harder to treat heel pain. Most guide lines limit steroid injections here to 1 or 2, and a 2012 randomised trial in the BMJ showed that ultrasound guidance improves the result of the steroid injection itself, which is a reason to decline any heel injection done by feel.
The case for PRP is the patient who has done 3 months of proper conservative treatment, has a confirmedthickened fascia on ultrasound, has had a steroid injection that faded or wants to avoid one, and wants atreatment with a better 6-month record. It is not the first thing to do, and a clinic offering it before stretchingand footwear have been tried has skipped the treatment with the strongest evidence.
message us on WhatsApp or email team@thewellnesslondon.com
What comes before any injection
First-line treatment for plantar fasciitis is not an injection, and the trials that favour PRP gave both groups the same conservative programme. Calf and plantar fascia stretching, done several times a day, addresses the reduced ankle flexibility that drives the condition. Supportive footwear with a firm heel and arch, and avoidingflat shoes and barefoot walking on hard floors, reduces load on the attachment. Weight reduction where relevant changes the force through the fascia with every step. Night splints, taping and heel cups help some patients. Extracorporeal shockwave therapy is supported by NICE interventional procedures guidance forrefractory cases and is a reasonable step before or alongside an injection.
The usual reason a heel that should have settled has not is that the programme was done for 2 weeks rather than 3 months, or the shoes did not change. A doctor here will ask about that before offering anything else,because an injection into a heel that is still being overloaded every day treats the symptom and leaves the cause.
message us on WhatsApp or email team@thewellnesslondon.com
A heel pain self-check before any injection
Not all heel pain is plantar fasciitis, and PRP into the wrong structure is money wasted. This does not replace an examination, but it tells you which conversation to have.
Pain under the heel, worst with the first steps in the morning or after sitting, easing as you walk andreturning after long standing. That is the classic plantar fasciitis pattern, and the one the PRP trials studied.
Pain in the centre of the heel pad that is worse walking barefoot on hard floors and feels like bruising, with no morning pattern. That fits fat pad atrophy, which steroid makes worse and PRP does not treat.
Burning, tingling or numbness spreading into the sole or the inner ankle. That suggests a nerve, eitherBaxter’s nerve at the heel or tarsal tunnel at the ankle, and needs a different assessment.
Pain at the back of the heel where the Achilles attaches, worse going up stairs or on tiptoe. That is Achillesinsertion, not the plantar fascia.
Heel pain after a sudden increase in running or walking, worse with every step, tender to squeeze the heel from both sides, with swelling. That can be a stress fracture and needs imaging before any injection.
Heel pain with fever, redness, or in a child or teenager. Those need a doctor promptly and not an injection clinic.
Our doctors put it this way. PRP earns its place in the heel that has done 3 months of the boring work and still hurts. Before that, the boring work is the treatment, and no injection replaces new shoes.
Message us on WhatsApp with how long the heel has hurt, what you have tried, and any imaging, and adoctor will give you a straight answer.
What PRP does not do for the heel
PRP does not help fat pad atrophy, nerve entrapment, Achilles insertion pain or a stress fracture, and a doctor should exclude those before injecting. At 12 months it is no better than steroid in the largest analysis, so it changes the middle of the recovery rather than its end. It does not remove the need for stretching, footwearand load management, and the trials that favour it gave both groups that programme. It is not routinely commissioned by the NHS for plantar fasciitis and private medical insurance rarely covers it. The injection itself is uncomfortable, since the fascia is sensitive and the heel is tight, and the heel is often sore for several days afterwards.
message us on WhatsApp or email team@thewellnesslondon.com
What heel PRP costs in London
Specialist central London clinics commonly charge from around £780 to £900 or more per image guided tendon or joint PRP injection including assessment, with a course of 2 to 3 taking a plan past £2,000, though most plantar fasciitis trials used a single injection. Image guided steroid injections in central London are commonly quoted between £250 and £475. Outside central London PRP is advertised from around £250 to£500, often without an ultrasound to confirm the fascia is the problem, which for a heel is the step that separates a treatable fascia from a nerve or a fat pad.
The reframing that matters is that most plantar fasciitis settles within a year with conservative care. What PRP buys, where it works, is a shorter middle of that year. For someone standing all day or unable to run, that has real value. For someone whose heel has hurt for 6 weeks, it is a purchase made too early.
Care at The London PRP Clinic by The Wellness is doctor-led and priced below flagship central London rates,with your exact figure confirmed at the free suitability review once a doctor has confirmed the diagnosis on ultrasound.
Ask about the cost for your heel on WhatsApp and we will explain what the review covers.
The free suitability review
Every enquiry here starts with a free, doctor-led suitability review rather than a booking. A GMC-registereddoctor assesses you and gives one of two answers. Either you are approved for treatment, with a clear plan and realistic expectations for your heel, or you are not approved, with an honest explanation of what would serve you better, whether that is a proper 3-month conservative programme, shockwave, a single guided steroid injection, or imaging to look for something other than the fascia.
We decline a meaningful share of the people who enquire. For heel pain that share is high, because most ofthe people who ask have not yet done the treatment with the best evidence.
message us on WhatsApp or email team@thewellnesslondon.com
Why people choose The London PRP Clinic by The Wellness
An 87 percent patient success rate across treatments.
More than 187 five star reviews.
Every treatment performed by a GMC-registered doctor.
100 supervised treatments completed by every clinician before they treat a patient here unsupervised.
A 32 percent average density increase reported in our hair restoration programme.
message us on WhatsApp or email team@thewellnesslondon.com
Frequently asked questions
Does PRP work for plantar fasciitis
Across 24 randomised trials and 1,653 participants, PRP gave better pain and function than a steroid injection at 3 and 6 months, with no difference at 1 month or 12 months. It works for chronic cases that have failed 3months of conservative treatment, and it is not a first-line option.
Is PRP better than a cortisone injection for heel pain
Cortisone works faster, with no difference in the first month. PRP is better at 3 and 6 months, and the two are level at 12 months. Cortisone carries a risk of fascia rupture and fat pad thinning with repeated use, which PRP does not.
How many PRP injections do you need for plantar fasciitis
Most trials used a single ultrasound-guided injection into the thickened fascia, with the same stretching andfootwear programme as the comparison group. A course of 2 or 3 is rarely supported by the plantar fasciitis evidence and should follow a doctor’s assessment, not a package.
How long does PRP take to work for plantar fasciitis
Slower than steroid. Trials show no advantage at 1 month, a clear advantage by 3 months and the largest difference at 6 months. The heel is often sore for several days after the injection, and stretching and footwearchanges continue throughout.
What should I try before PRP for heel pain
At least 3 months of calf and plantar fascia stretching several times daily, supportive footwear with a firm heel,avoiding barefoot walking on hard floors, weight reduction where relevant, and shockwave therapy, which NICE guidance supports for refractory cases. Most plantar fasciitis settles within a year on this alone.
Is PRP for plantar fasciitis available on the NHS
PRP is not routinely commissioned by the NHS for plantar fasciitis or other tendon and fascia conditions, and private medical insurance rarely covers it. Steroid injections, physiotherapy and in some areas shockwave are available on the NHS. Almost all PRP is self-pay.
message us on WhatsApp or email team@thewellnesslondon.com
References
American Journal of Physical Medicine and Rehabilitation, 2025. Platelet-rich plasma versuscorticosteroids in the treatment of plantar fasciitis, a systematic review and meta-analysis of 24randomised trials. https://pubmed.ncbi.nlm.nih.gov/39778212/
American Family Physician, 2021, summarising the 2017 meta-analysis of 9 randomised trials and the2019 review of corticosteroid versus PRP for plantar fasciitis.https://www.aafp.org/pubs/afp/issues/2021/0301/p307.html
Journal of Foot and Ankle Surgery, 2020. Platelet-rich plasma versus corticosteroids in the treatment of chronic plantar fasciitis, a meta-analysis of 21 randomised trials.https://www.sciencedirect.com/science/article/abs/pii/S1067251619303953
BMC Musculoskeletal Disorders, 2023. Sharma et al. Effect of platelet-rich plasma versus steroid injection in plantar fasciitis, a randomised clinical trial. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9989576/
Orthopaedic Journal of Sports Medicine, 2020. Platelet-rich plasma versus corticosteroids for plantar fasciitis, a systematic review of randomised controlled trials, citing the Cochrane finding of no long-termcorticosteroid benefit at 6 months. https://pmc.ncbi.nlm.nih.gov/articles/PMC7222276/
Central London clinic price lists for image guided PRP and steroid injections, accessed September 2026.
This article is for general information and does not replace a medical assessment. Speak to one of our doctors before deciding whether PRP is right for your heel.
