Ultrasound-Guided Zhengqing Fengtongning vs Corticosteroid Injections for Plantar Fasciitis: A Randomized Controlled Trial on Short- and Long-Term Efficacy

BACKGROUND Plantar fasciitis is a common cause of chronic heel pain. Corticosteroid injections provide short-term relief but carry long-term risks of fascia degradation. Zhengqing Fengtongning (ZQFTN), a sinomenine hydrochloride-based herbal extract, shows anti-inflammatory effects in musculoskeletal disorders, although evidence for plantar fasciitis remains limited. Ultrasound-guided injection enables precise pathological targeting. MATERIAL AND METHODS In this single-center RCT, 54 patients with chronic plantar fasciitis were randomized to ultrasound-guided ZQFTN (n=27) or corticosteroid (n=27) injections. Primary outcomes included VAS pain scores, AOFAS foot function, and plantar fascia thickness via ultrasound at baseline, 1 week, 1 month, and 3 months. RESULTS Both groups demonstrated significant improvements over time: within-group analyses showed progressive reductions in VAS scores (P<0.05) and increases in AOFAS scores (P<0.05) at all follow-up points, alongside significant thinning of plantar fascia thickness at 1 and 3 months (P<0.05). Between-group comparisons revealed that at 3 months, the observation group exhibited significantly lower VAS scores (P<0.05) and higher AOFAS scores (P<0.05) than the control group. Ultrasonographic measurements further indicated more pronounced reductions in plantar fascia thickness in the observation group at 1 month (P<0.05) and 3 months (P<0.05). CONCLUSIONS Ultrasound-guided injection therapy ensures precise targeting of the pathological fascia, with Zhengqing Fengtongning demonstrating superior long-term efficacy and a better safety profile compared to corticosteroids.