Plantar fasciitis, or PF, is one of the most prevalent causes of heel pain in the United States, affecting around 2 million people.

It is caused by inflammation of the plantar fascia, a band of connective tissue that runs from the heel to the toes and supports the arch of the foot.

“Plantar fasciitis is exceptionally painful. When you get up from a sitting position or from sleeping, it’s a sharp, searing pain that some people describe as being like a nail going right through their heel,” says Beth Gusenoff, D.P.M., clinical assistant professor of plastic surgery at Pitt

Stretching, shoe orthotics, and cortisone injections can be used to treat the acute form of PF. However, about 10% of people have a chronic version of the condition, in which the foot’s collagen degenerates and the plantar fascia thickens.

According to Beth Gusenoff, surgical release of the plantar fascia with a minor cut can help these patients, however this treatment comes with complications.

“Recently, there has been a plea among podiatrists to stop cutting the plantar fascia because some people get a lot of scar tissue, which causes pain,” she explains. “And if too much is cut, the foot can become destabilized, so people end up with almost like a floppy foot.” 

Regenerative properties of fat stem cells led the Gusenoffs to come up with a way to get fat from a patient’s belly or another part of the body and use it to make new tissue.

“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,” adds Jeffrey 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.” 

The researchers divided 14 individuals with chronic PF into two groups to test this strategy. Participants in Group 1 underwent the procedure at the start of the trial and were observed for a year, whereas those in Group 2 received it after a six-month observation period and were followed for another six months.

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

Six months following the treatment, Group 2 demonstrated decreased plantar fascia thickness and increased sports activity, as well as a minor, but not statistically significant, improvement in pain levels. The researchers believe that if they had a larger sample size and a longer follow-up period, they would have noticed stronger benefits in this group.

This study, according to the Gusenoffs, proves that fat injections can be used to treat PF, and they are currently planning a bigger clinical trial to confirm their findings.

They hope that with enough evidence, the operation will be recognized as a medical necessity, allowing it to be paid by insurance and become more generally available in the future.

Image Credit: Getty

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