Plantar fasciitis is a degenerative tissue condition occurs at the site of origin of plantar fascia at the medial calcaneum tuberosity. Most common symptom is described as first step pain. The treatment includes heat modalities, patient education, stretching and strengthening exercises, NSAIDS, injections (steroids, local anesthetics, PRP), and surgical interventions (fasciotomy).

It is a prospective and interventional randomised comparative study. Eighty cases (40 in each group) in otherwise healthy individuals with the diagnosis of unilateral or bilateral plantar fasciitis attending Outpatient department of PMR of VMMC & Safdarjung hospital were enrolled in this study. The diagnosis of plantar fasciitis was made based on history and clinical examination. Patients who satisfied inclusion and exclusion criteria was randomly assigned by computerised block method into two groups-both were treated with injection of 40mg (1ml) methyl prednisolone, one group with palpation guided and other with ultrasound guided. All patients underwent pain intensity assessment by VAS, ultrasound examination and X-ray at preinjection (0 week), 2 weeks and 8 weeks after steroid injection.

Statistically significant improvement in pain (VAS) at the end of 2 weeks (3.25±0.95 vs. 2.65±0.83, P=0.003) and 8 weeks (2.28±1.24 vs. 1.12±1.07, P=0.0005) of intervention in both groups but more in the USG guided group. There was decrease in plantar fascia thickness at the end of 2 weeks (0.33±0.02 vs. 0.31±0.02, P=0.0005) and 8 weeks (0.30±0.02 vs. 0.28±0.02, P=0.0005) of intervention in both groups but more in the USG guided group, which was statistically significant. No statistically significant difference in heel pad thickness at the end of 2 weeks (18.08±0.76 vs. 18.23±0.80, P=0.356) and 8 weeks (18.00±0.75 vs. 18.12±0.79, P=0.444) of intervention in both groups.

Ultrasound guided injection is better than palpation method as it enhances the accuracy of injection by precisely localising the lesion and needle placement giving more relief in symptoms and normalisation of plantar fascia thickness.