Thirty-eight physical therapy ineffective plantar fasciitis patients were enrolled in this study, and randomly divided into ultrasound-guided and palpation-guided groups. Pain intensity was measured using a visual analog scale (VAS) and plantar fasciitis were evaluated by high frequency ultrasound including assessment of the thickness before injection and at 4 weeks, 12 weeks post injection.

Thirty-eight patients who received either ultrasound guided or palpation-guided injection had significantly lower visual analog scale scores and lower plantar fascia thickness (both P<0.01) at 4 weeks, 12 weeks post injection. The differences in plantar fascia thickness, VAS score between the two groups before, and at the 4 weeks follow-up were not statistically significant [2.52±0.77 vs 2.68±0.82, P>0.05; (4.56±0.25)?mm vs (4.72±0.38)?mm, P>0.05]. However, the ultrasound guided group had lower mean visual analog scale score (1.47±0.77 vs 2.37±0.68, P<0.01) and lower mean plantar fascia thickness [(4.02±0.24)?mm vs (4.53±0.35)?mm, P<0.01] than the palpation-guided group at 12 weeks post injection. The calcification of the plantar fascia at 12 weeks post injection in ultrasound guided group was completely disappeared or significantly decreased.

Ultrasound-guided injection for treating plantar fasciitis is more accurate and effective than palpation-guided injection, and is of great clinical value for both patients and doctors.