Corticosteroid versus placebo injection for plantar fasciitis: A meta-analysis of randomized controlled trials

Abstract

The aim of this meta-analysis was to determine the efficacy of corticosteroid versus placebo injection for the treatment of plantar fasciitis. Databases (Medline, Embase, the Cochrane Library and Google Scholar) and study references were searched for randomized controlled trials comparing corticosteroid with placebo injection for plantar fasciitis. Studies that met the inclusion criteria were selected for the analysis. The risk of bias tool was used for the methodological assessment. Outcomes including visual analogue score (VAS) and plantar fascia thickness (PFT) were extracted and pooled. Egger's test was used to detect publication bias. The evidence quality was assessed by the Grading of Recommendations Assessment, Development and Evaluation system. Statistical analysis was performed using RevMan 5.2. A total of four studies with 289 patients were included in the analysis. Compared with the placebo, corticosteroid injection provided better pain relief after one month [standardized mean difference (SMD), -0.32; 95% confidence interval (CI), -0.59--0.06); P=0.02). No difference was detected with respect to the VAS after two months (SMD, -0.04; 95% CI, -0.35-0.27; P=0.79) or three months (SMD, -0.42; 95% CI, -1.00-0.16; P=0.15) or to the PFT (MD, 0.70; 95% CI, -1.77-0.38; P=0.20), although a tendency of favoring corticosteroid injection was observed. No obvious publication bias was detected. In conclusion, corticosteroid injection may provide pain relief for a short period of time, but the efficacy may disappear with the progression of time.