Marc Darrow, MD, JD.

Doctors may offer stem cell injection therapy to plantar fasciitis patients as a non-surgical and regenerative approach to rebuilding damaged tissue. In our practice, ultrasound guidance is used to help place the treatment.

The goal of the treatment is to rebuild damaged and strengthen soft tissue. By supporting healing of the fascia, stem cell therapy can help reduce inflammation and pain. However, some research suggests that stem cells work, but the “other way around.” A June 2025 study (1) notes that in cases of tendinopathy, mesenchymal stem cells contribute to healing not through direct tissue regeneration, but primarily via their anti-inflammatory and pain reducing properties. MSCs work by decreasing the infiltration of mononuclear cells (cells that create swelling and inflammation) into the affected tendon tissue. Additionally, they facilitate the shift of macrophages (repair and clean up cells) toward the M2 phenotype (an alternative version focusing on tissue repair), which is associated with regeneration. This immunomodulation  enhances the healing environment of the tendon, leading to improved outcomes for patients.

Stem cell therapy in the form of concentrated bone marrow aspirate concentrate (BMAC) injections

A January 2026 study (2) investigated the effectiveness of concentrated bone marrow aspirate concentrate (BMAC) injections in patients with plantar fasciitis who did not respond to conventional treatment. Patient data was analyzed in those diagnosed with chronic plantar fasciitis who received BMAC injections. Bone marrow aspirate was harvested from the iliac crest, concentrated, and injected into the area of pain points in the plantar fascia. Visual analogue scale (VAS) pain scores were documented prior to and following the BMAC injection at six, ten, 24, and 48 weeks. Results: Patients experiencing persistent plantar fasciitis who underwent BMAC injection demonstrated and maintained a statistically significant decrease in VAS pain scores during assessments at each postoperative follow-up, lasting up to 48 weeks, with no adverse effects noted at either the donor or injection sites. These findings suggest that BMAC injection may serve as a safe treatment option that offers rapid pain relief.

Other treatments 

A March 2026 study (3) showed that while corticosteroid injections result in better short-term improvements in pain and functionality, dextrose prolotherapy offers a higher mid-term Functional Gain Index (FFI) and achieves more effective overall pain alleviation when ultrasound guidance is utilized. Both treatment modalities exhibit similar pain relief (as measured by morning and walking Visual Analog Scale (VAS)) and a reduction in plantar fascia thickness after three months, accompanied by low rates of adverse events.

In a study released in February 2026 (4), researchers looked at data from 63 randomized controlled trials involving 4,170 participants to see how well extracorporeal shock wave therapy, prolotherapy, and various injection treatments work for people with plantar fasciitis. The injection treatments examined included platelet-rich plasma, botulinum toxin A, corticosteroids, autologous blood, and local anesthetics. Botulinum Toxin A: This treatment had the best short-term results for pain relief and helped reduce the thickness of the plantar fascia. Prolotherapy: Among all the treatments, prolotherapy was the most effective for providing long-lasting pain relief during the mid- and long-term follow-ups. Corticosteroid Injection: The use of corticosteroids resulted in the greatest short-term improvements in patients’ ability to function. Platelet-Rich Plasma: This treatment showed important long-term benefits for both functional ability and the thickness of the plantar fascia. Extracorporeal Shock Wave Therapy: This method was effective in all areas we looked at and showed good results at every follow-up time.

A February 2026 published clinical study (5) evaluated the effectiveness of four injection treatments for plantar fasciitis in 83 patients, measuring pain reduction over three months. The groups receiving peppering with corticosteroid and corticosteroid alone showed greater pain relief compared to peppering alone or autologous blood injection. Peppering alone yielded significant improvement only at three months, while autologous blood injections did not produce notable short-term benefits. The combination of peppering and corticosteroid provided the most sustained pain relief.

A March 2026 paper (6) finds “dextrose prolotherapy has been shown to be effective in reducing pain in the short and medium term, proving superior to placebo or isolated conservative therapies, and emerging as a valid cost-effective alternative.”

References

1 Liebmann K, Kimbrough DW, Best TM, Kouroupis D, Rodriguez Materon S. Plantar fasciitis pathophysiology and the potential role of mesenchymal stem cell-derived extracellular vesicles as therapy. Biomedicines. 2025 Jun 23;13(7):1528.
2 de Cesar Netto C, Day J, Auster H, Schon L. Outcomes of iliac crest bone marrow aspirate injection in the treatment of recalcitrant plantar fasciitis. International Orthopaedics. 2026 Jan 5:1-5.
3 Qafesha RM, Ishreiteh HA, Nassourah AL, Tawil OI, Mashaly D. Efficacy and Safety of Dextrose Prolotherapy Versus Corticosteroid Injections in Plantar Fasciitis: A Systematic Review and Meta-Analysis. Journal of foot and ankle research. 2026 Mar;19(1):e70135.
4 Tien CH, Chiu MC, Shen YL, Ko YC, Lee JJ. Comparative effectiveness of minimally invasive therapies for plantar fasciitis: a systematic review and network meta-analysis. Scientific Reports. 2026 Feb 14.
5 Öner R, Özgezmez FT, Sönmez O, Demir E. Comparison of Injection Methods for the Treatment of Plantar Fasciitis: A Comparative Study. The Journal of Foot and Ankle Surgery. 2026 Feb 10.
6 Távara-Vidalón P, Lloret-González JM, Alcalá-Cruz M. Diagnosis and current therapeutic management of chronic plantar fasciitis. Med Clin (Barc). 2026 Mar 3;166(5):107375. English, Spanish. doi: 10.1016/j.medcli.2026.107375. Epub ahead of print. PMID: 41780307.