PRP or Shockwave for Plantar Fasciitis: What the Evidence Means for Heel Pain

PRP and shockwave therapy are both discussed for persistent plantar heel pain, but neither is a shortcut around getting the diagnosis right and following a rehabilitation plan. Some trials favour PRP for pain, yet reviews do not show a consistent advantage across every measure of function. The right question is which option, if any, is worth adding to your existing care.

The London PRP Clinic by The Wellness offers assessment for people considering PRP. This article compares the evidence; it is not a claim that shockwave is provided at the clinic. Discuss your heel pain with the team, call 020 3951 3429 or email team@thewellnesslondon.com.

First make sure the pain is plantar fasciitis

Heel pain is a symptom, not a diagnosis. Its location, onset, effect on walking and response to activity help a clinician decide what needs checking. Do not assume every painful heel needs an injection because a scan or an article mentions the plantar fascia.

Explain any injury, how long you have had the pain, what you have tried and how it limits you. The clinician can advise whether an examination or imaging is useful. If pain follows a significant injury, you cannot bear weight, or you feel acutely unwell, seek prompt assessment rather than booking a routine injection appointment.

What the two treatments involve

PRP is platelet-rich plasma prepared from your own blood and injected into a target area. Shockwave therapy applies acoustic energy externally rather than injecting a blood product. The treatment burden, discomfort, appointments and recovery advice differ. Ask the treating clinician for the actual protocol rather than assuming every clinic uses the same approach.

Neither option guarantees pain relief or tissue repair. A comparison should include the diagnosis, previous rehabilitation, practical recovery demands and the quality of evidence for your situation.

What a 2024 review found

A systematic review by Herber and colleagues, published in Foot and Ankle Surgery in 2024, pooled 21 randomised trials involving 1,356 people across several treatment comparisons. PRP produced greater improvement in visual analogue pain scores than shockwave, corticosteroid injection and placebo in the comparisons analysed.

That is not the same as saying PRP was better in every way. The review found no significant difference between PRP and shockwave on the Foot Function Index, and PRP did not show a consistent advantage across all outcomes. The authors called for more standardised PRP preparation and outcome measurement.

These distinctions matter. A statistically different pain score does not tell you the chance that you personally will return to running, how soon you will improve or whether the difference will feel worthwhile. The review should support a discussion, not a guaranteed-results claim.

Why guidance remains cautious

NICE's guidance on autologous blood injection for plantar fasciitis includes platelet-rich plasma. It states that evidence on efficacy is inadequate in quantity and quality and recommends use only with special arrangements for clinical governance, consent and audit or research. That guidance is an important counterweight to encouraging trial results.

Ask a clinician how this applies to the proposed treatment, how uncertainty will be explained and how your outcome will be reviewed. A responsible consent discussion covers the possibility of little or no improvement as well as potential benefit.

Rehabilitation is still part of the decision

Before choosing an additional procedure, review what your current plan contains, whether it has been practical to follow and how progress has been measured. The number of weeks you have had pain is not the same as the number of weeks you have followed a suitable rehabilitation programme.

Ask whether footwear, activity demands and exercise progression have been considered. Do not stop a rehabilitation plan or change medicines on the strength of this article. Your clinician should advise what to continue and what, if anything, to change around a procedure.

Arrange an assessment before choosing PRP. An assessment should leave you with a clear reason for the proposed option, including when not to proceed.

Compare the whole treatment pathway

PRP involves a blood draw and injection. Shockwave does not involve injecting a blood product. Neither guarantees benefit, and protocols vary. For PRP, ask about preparation, injection plan, risks, aftercare and review. For shockwave, ask about the device, session plan, discomfort and review.

An injection carries risks including pain, bruising, bleeding and infection. Your own blood being used does not make a procedure risk-free. Ask the treating clinician to explain personal risks and the aftercare contact route.

Questions worth taking to your consultation

- What is the working diagnosis, and what else has been considered?

- Have I completed an appropriate rehabilitation plan?

- Which study is most relevant to my situation, and what did it actually measure?

- What improvement would count as worthwhile for me?

- What happens if the first treatment does not help?

- What is included in the total cost, and when is the review?

Cost and booking

The clinic's musculoskeletal PRP fee is £750. Confirm whether PRP is suitable for your heel, what the proposed treatment includes and whether assessment, imaging or other care is charged separately before proceeding. This article does not quote a shockwave price or promise availability of that treatment at The Wellness.

Enquire on WhatsApp, call 020 3951 3429 or email team@thewellnesslondon.com.

Questions people ask

Is PRP better than shockwave for plantar fasciitis?

Some pooled trial results favour PRP for pain, but not consistently for function or every other outcome. That does not establish that it is the best option for everyone.

Is PRP a proven cure for heel pain?

No. Evidence and protocols vary, and NICE guidance remains cautious. Diagnosis, consent and review are important.

Can I skip rehabilitation if I choose an injection?

Do not assume so. Ask how the procedure would fit into your rehabilitation and activity plan.

Sources

- Herber et al., Foot and Ankle Surgery, 2024: PRP versus other modalities for plantar fasciitis

- NICE: autologous blood injection for plantar fasciitis

This article is general information, not a diagnosis or an individual treatment recommendation.