Fat injection appears to reduce pain in plantar fascitis

Injection of a patient’s fat into the sole of the foot appears to offer relief from the pain of plantar fasciitis, researchers from a pilot study reported on Jan. 25, 2022 in Plastic & Reconstructive Surgery.

“We developed this procedure to harness the regenerative properties of fat,” said Jeffrey Gusenoff, M.D., professor of plastic surgery at the University of Pittsburgh Medical School. “In this proof-of-concept study, we showed that fat injections into the foot reduced heel pain, helped patients get back to doing sports and activities and boosted quality of life.”

The authors noted that plantar fasciitis is a cause of heel pain affecting an estimated 2 million people in the United States. The condition involves inflammation of the plantar fascia, connective tissue between the heel and toes which also supports the arch of the foot.

The investigators tested the hypothesis that fat injections might decrease plantar fascia thickness, reduce pain, and improve quality of life. “In fat, there are stem cells and growth factors that help bring in fresh blood supply, which drives a mode of wound healing with reduced scarring,” said Gusenoff. “We use a blunt needle to perforate the plantar fascia, which makes a small injury to stimulate the healing process. Then, when we pull the needle back, we inject a little bit of the patient’s fat.”

Adults with plantar fascia for whom standard treatment had failed were eligible for the study.

The investigators recruited 14 subjects with chronic plantar fascia. They divided them into two groups. Subjects in Group 1 (n=7) underwent the procedure at the beginning of the study and were followed for 12 months. Subjects in Group 2 (n=7) underwent the procedure after a six-month observation period; they were followed for six months.

“We found that Group 1 had improvements in quality of life and sports activity, decreased plantar fascia thickness and reduced pain levels,” said Gusenoff. “And a lot of the measures that were improving six months after the procedure got even better by 12 months.”

Group 2 subjects achieved decreased plantar fascia thickness and increased sports activity six months after the procedure. They also achieved non-significant, improvement in pain levels.

“In conclusion,” the authors said, “perforating fat injections for chronic plantar fasciitis demonstrate significant improvement in pain, function, and plantar fascia thickness.