Comparative analysis of corticosteroid injection alone versus combined corticosteroid and radiofrequency ablation for plantar fasciitis: short- and medium-term outcomes.

Background/aim: Plantar fasciitis (PF) is a common cause of heel pain and may lead to functional impairment and reduced quality of life. This study aimed to compare the short- and medium-term clinical outcomes of corticosteroid injection (CSI) alone versus combined radiofrequency ablation (RFA) and CSI in patients with PF refractory to conservative treatment. Materials and methods: This single-center retrospective comparative study included patients diagnosed with PF between 1 January 2021 and 1 January 2025. Patients who underwent either CSI alone or combined RFA and CSI after failure of conservative management were included. Pain intensity was assessed using a visual analog scale (VAS) at baseline, 1 week, 3 months, and 6 months. Global perceived effect (GPE) scores were evaluated at 1 week, 3 months, and 6 months. Results: Both treatment groups demonstrated significant improvements in VAS scores at 1 week, 3 months, and 6 months compared to baseline (p < 0.001 for all). Baseline and 1-week VAS scores were comparable between the groups (p > 0.05). However, median VAS scores at 3 and 6 months were significantly lower in the group receiving combined RFA and CSI compared to CSI alone (p < 0.001). GPE scores at 1 week did not differ significantly (p = 0.100), but at 3 and 6 months, they were significantly higher in the combined group (p < 0.001). In adjusted longitudinal analysis, the group receiving combined RFA and CSI had lower overall VAS scores over time, with significant group × time interactions at 3 and 6 months. Conclusion: Both CSI alone and combined RFA and CSI provide significant short- and medium-term pain relief. However, the addition of RFA to CSI is associated with superior midterm pain control and greater patient-reported clinical improvement.