Short-term efficacy and safety of hyaluronic acid injection for plantar fasciopathy

Tsukasa Kumai*, Norihiro Samoto, Atsushi Hasegawa, Hideo Noguchi, Atsushi Shiranita, Masaharu Shiraishi, Satoshi Ikeda, Kazuya Sugimoto, Yasuhito Tanaka, Yoshinori Takakura

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Purpose: Plantar fasciopathy is the most common cause of plantar heel pain and is considered to be a type of enthesopathy. The short-term efficacy, safety, and dose-response relationship of high-molecular-weight hyaluronic acid (HA) was investigated in patients with plantar fasciopathy. Methods: In this multicenter, prospective, randomized, double-blind, placebo-controlled trial, 168 patients with persistent pain from plantar fasciopathy for more than 12 weeks were randomly assigned to receive 2.5 mL of 1% HA (H-HA), 0.8 mL of 1% HA (L-HA), or 2.5 mL of 0.01% HA (control group) once a week for 5 weeks. The primary endpoint was improvement in visual analogue scale (VAS) score for pain from baseline to week 5. Results: The VAS scores (least squares mean ± standard error) in each group decreased gradually after the start of treatment, a change of −3.3 ± 0.3 cm for the H-HA group, −2.6 ± 0.3 cm for the L-HA group, and −2.4 ± 0.3 cm for the control group, with the H-HA group improving significantly more than the control group (P = 0.029). No serious adverse events were reported. There was no difference between the groups in the incidence rates of adverse drug reactions. Conclusion: The administration of five injections of high-molecular-weight HA is an effective treatment with no serious adverse drug reactions and is a conservative treatment option for plantar fasciopathy. This treatment contributed to alleviation of pain in patients with plantar fasciopathy and improvement in their activities of daily living. Level of evidence: I.

Original languageEnglish
Pages (from-to)903-911
Number of pages9
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Issue number3
Publication statusPublished - 2018 Mar 1
Externally publishedYes


  • Double-blind
  • Enthesopathy
  • Heel pain
  • Hyaluronic acid
  • Plantar fascia
  • Randomized controlled trial

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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