# Efficacy and Safety of Dextrose Prolotherapy Versus Corticosteroid Injections in Plantar Fasciitis: A Systematic Review and Meta‐Analysis

## TL;DR

This study compares dextrose prolotherapy and corticosteroid injections for treating plantar fasciitis, finding corticosteroids more effective short-term but similar results over time.

## Contribution

A systematic review and meta-analysis comparing the short- and mid-term efficacy and safety of dextrose prolotherapy and corticosteroid injections for plantar fasciitis.

## Key findings

- Corticosteroid injections reduced pain and improved foot function more effectively than dextrose prolotherapy in the short term.
- At 3 months, dextrose prolotherapy showed better foot function improvement compared to corticosteroid injections.
- Both treatments had similar efficacy in the mid-term, but corticosteroids had greater initial benefits.

## Abstract

Plantar fasciitis (PF) is a common cause of heel pain that affects the health‐related quality of life of many individuals and has various treatment options. Two effective interventions are corticosteroid (CS) injections and dextrose prolotherapy (DP). This study aimed to compare the efficacy and safety of DP and CS in patients with PF systematically.

Relevant studies, including those comparing DP and CS for treating PF, were identified by searching electronic databases until August 2025. The visual analog scale (VAS) pain score, foot function index (FFI), and plantar fascia thickness (PFT) were compared between the groups in the short term (0.5–1 month) and mid‐term (3 months). Statistical analyses were performed via RevMan 4.5.1, and p < 0.05 was considered statistically significant.

Five RCTs and two cohort studies, with a total of 567 patients, were included in the meta‐analysis. The analysis revealed that at the short‐term follow‐up (1 month), corticosteroid injections were more effective at reducing the VAS pain scores than dextrose prolotherapy for general VAS score (MD = 1.85, 95% CI [0.05, 3.64], p = 0.04), the VAS score at the first step in the morning (MD = 1.26, 95% CI [0.49, 2.02], p = 0.001), and the VAS score for pain while walking (MD = 1.85, 95% CI [0.68, 3.02], p = 0.002). Similarly, at the short‐term follow‐up (1 month), the analysis revealed a significantly greater reduction in the FFI score (MD = 18.81, 95% CI [0.06, 37.55]) and PFT (MD = 0.26 mm, 95% CI [0.07, 0.45]) in the CS group than in the DP group. At 3 months, the analysis revealed a significant decrease in the FFI score (p = 0.003) in the DP group compared with the CS group, whereas no significant difference was observed in the VAS scores or PFT.

In patients with plantar fasciitis, CS injections had greater efficacy than DP did in the short term; however, their efficacy became similar in the mid‐term follow‐up, with DP outperforming CS in terms of foot function. Further trials with standardized protocols and long‐term follow‐ups are needed to address potential biases.