What Is PRP Therapy for Heel Pain?
Platelet-rich plasma (PRP) therapy for heel pain uses your own blood that's been processed to concentrate healing 
platelets—containing growth factors that restart your body's stalled healing process. Unlike cortisone which masks inflammation temporarily, PRP actually repairs damaged plantar fascia tissue by delivering concentrated healing factors directly to the injury site.
Think of PRP as liquid gold for healing. Here's how it works. We draw a small amount of blood from your arm—about the same amount as a routine blood test. Then we place it in a centrifuge that spins it down and separates the platelets from the red blood cells. This concentrates your platelets about 3-5 times higher than what's normally in your bloodstream.¹ These concentrated platelets are packed with growth factors—specialized proteins that signal your body to send healing cells to an injured area.
The real magic happens when we inject this concentrated PRP directly at the point where your plantar fascia attaches to your heel bone. I use ultrasound guidance to make sure it goes exactly where it needs to go. Your plantar fascia has relatively poor blood supply, which is why it struggles to heal on its own. By delivering concentrated growth factors right to the damaged tissue, we're giving your body the resources it needs to restart and complete the healing process it began months ago.
It's like bringing in a new construction crew with all the right tools to finish the job the original crew couldn't complete.
Why PRP Works Where Cortisone Fails
If you've had a cortisone shot before, you know the pattern. You feel better within a day or two. Maybe you even think the problem's fixed. Then two, three months later, the pain comes roaring back—often worse than before.
Here's why that happens. Cortisone is designed to block inflammation—it's really good at making you feel better fast. But it doesn't provide any healing materials. It's just masking the problem while your body continues to struggle with that failed healing response. And here's what most people don't realize: repeated cortisone injections actually weaken tendons and ligaments over time. You're trading short-term relief for long-term problems.
PRP works completely differently. Instead of blocking inflammation, it provides the actual building blocks your body needs to repair damaged tissue. Studies show that cortisone patients return to baseline pain levels at 24 months, while PRP patients maintain their improvement.² The timeline's different too. With cortisone, you get relief in 2-4 days but it only lasts 2-3 months. With PRP, you'll wait 2-4 weeks for initial improvement, but the results typically last 24 months or longer.
After treating thousands of patients with both cortisone and PRP, I can tell you the difference is dramatic. Cortisone patients come back every few months for another shot. PRP patients typically need one treatment, maybe two, and they're done.
The Failed Healing Response: Why Your Heel Pain Won't Go Away
You've probably wondered why your heel pain just won't heal. You rested it. You stretched. You iced it. You bought better shoes. Some of those things helped a little, but nothing made it go away completely.
Here's what's actually happening. Your body did try to heal the damaged plantar fascia. It sent inflammatory cells to the area, started laying down new tissue, began the repair process. But then the process stalled out. We call this a failed healing response—it's like having a construction crew that started a job but never finished it. The damage is still there, the inflammation continues, but your body can't move past this stuck point to complete the repair.
Why does it stall? Your plantar fascia has relatively poor blood supply compared to other tissues in your body.³ Blood carries oxygen and nutrients—the raw materials needed for healing. Without adequate circulation, your body simply doesn't have enough resources at the injury site to finish what it started. Time makes it worse too. The longer this goes on, the more scar tissue forms, and scar tissue has even less blood supply than normal tissue.
This is why you get that searing pain first thing in the morning. During the night, your body makes another attempt at healing and the plantar fascia contracts as it tries to repair itself. When you take those first steps out of bed, you're literally tearing apart whatever repair work your body managed overnight. That's the technical term for that morning heel pain—it tells you your body's stuck in this failed healing cycle.
PRP injections break this cycle. By delivering concentrated growth factors directly to the damaged tissue, we're giving your body the resources it needs to restart and complete the healing process it began months ago.
Houston Podiatrist Treats Heel Pain with Combined PRP and Shockwave Therapy
In most medical offices, doctors are trained to think in terms of medicate or operate. If medication doesn't work, the next step is surgery. But what if there's a third option that most doctors never mentioned? In my Houston podiatry practice, I've found that combining PRP injections with shockwave therapy creates a powerful healing protocol that helps 85-95% of patients avoid surgery altogether.
Level 1: Conservative Care You've Probably Already Tried
Look, if you're reading about PRP injections, I'm guessing you've already done the basics. Custom orthotics to support your arch. Activity modification to reduce stress on your heel. Proper footwear with good cushioning and support. Stretching exercises for your calf and plantar fascia. When we catch plantar fasciitis early, these conservative approaches work for about 70-80% of patients.
But here's the reality: if you're researching PRP injections, you've probably already tried all that. You wouldn't be looking into regenerative medicine if rest and stretching had worked.
Level 2: The Cortisone Reality
I could give you a cortisone shot today and you'd feel better by tomorrow. But I'd also know you'll be back in my office in 8-12 weeks when the pain returns.
I don't judge patients who choose cortisone for short-term relief—sometimes you have an event coming up or need to get through a busy season at work. Either way, I need to see you to discuss all your options.
But if you're looking for a lasting solution, we need to talk about regenerative medicine. Cortisone's a temporary band-aid. It reduces inflammation but doesn't provide any healing materials. And with repeated injections, it actually weakens your plantar fascia over time. That's why the relief gets shorter with each shot and why some patients end up with plantar fascia ruptures after multiple cortisone injections.
Level 3: The Combined Protocol That Changes Everything
Here's what I've discovered after treating thousands of patients with chronic heel pain: PRP works better when we combine it with shockwave therapy. Let me explain why. It's like planting seeds in a garden. PRP provides the seeds—the growth factors and signaling proteins that tell your body to repair damaged tissue. Shockwave therapy prepares the soil and creates optimal growth conditions. Together, they create a powerful healing environment that can succeed where other treatments have failed.
The Shockwave Component
Shockwave therapy uses acoustic pressure waves—not electric shocks—to stimulate healing. Think of it like aerating your lawn. When you aerate a lawn, you're creating channels that allow water, nutrients, and oxygen to reach the grass roots more effectively. Shockwave does the same thing for your plantar fascia. It creates microscopic channels in the tissue that allow healing factors to penetrate deeper.
Each shockwave session takes about 10-15 minutes. I'll apply the device to your heel and you'll feel a tapping sensation. We can adjust the intensity based on your comfort level. Some discomfort during treatment actually indicates we're hitting the right spot. Most patients describe it as tolerable—you might have some redness or soreness afterward that resolves within 24 hours.
The protocol is typically three sessions, once weekly. Shockwave therapy alone has an 82% success rate for chronic plantar fasciitis.⁴
The PRP Component
For the PRP injection, we start with a blood draw from your arm. The whole process takes about an hour—most of that 
is processing time in the centrifuge while you're relaxing in the exam room. Once we have your concentrated platelets, I use ultrasound guidance to inject them precisely at the point where your plantar fascia attaches to your heel bone.
I won't lie to you—the injection itself is uncomfortable. But it's over quickly, and the discomfort you feel afterward for a day or two is actually a sign that the healing process is starting. We'll have you ice it and take acetaminophen if needed. Do not take NSAIDs like ibuprofen or naproxen—they interfere with the inflammatory response that PRP is trying to stimulate.
The Treatment Sequence
Here's how we typically structure the combined protocol. Week 1, we do the PRP injection to deliver those concentrated growth factors. Week 2, we start shockwave therapy to activate those factors and create optimal conditions for healing. Weeks 3 and 4, we continue shockwave treatments to maintain that healing environment.
Success Rates and Timeline Expectations
Shockwave therapy alone has an 82% success rate. PRP alone works for about 70-80% of chronic cases. But when we combine them? We're seeing 85-95% of patients experience significant, lasting improvement.⁵
Now, I need to be honest about timelines. This isn't like cortisone where you feel better tomorrow. PRP works by stimulating your body's natural healing processes. Most patients begin noticing improvement within 2-4 weeks, with continued improvement over the following months. The full benefit might not be apparent until 3-6 months after treatment, but the results tend to be lasting—unlike cortisone's 2-3 months.
Let's Talk About Cost
I know that's on your mind. PRP runs $850. The shockwave package is $750 for three sessions. So you're looking at $1,600 total for the combined protocol.
Currently, most insurance plans including Medicare don't cover these treatments. They're considered cash-pay procedures, though some FSAs or HSAs will cover them. I know that sounds like a lot upfront. But compare it to months of physical therapy co-pays, repeated cortisone injections every few months, or the cost of surgery plus weeks off work for recovery. Most patients tell me it's actually more cost-effective in the long run.
Level 4: When Surgery Becomes Necessary
Look, I know that foot surgery sounds scary. But I'll be straight with you—about 5% of plantar fasciitis cases do eventually need surgery. Usually that's after we've tried everything else, including the combined PRP and shockwave protocol.
If we get to that point, modern surgical techniques are much less invasive than they used to be. Plantar fascia release surgery involves making a small incision and releasing part of the tight fascia to reduce tension. Most patients walk the same day in a protective boot, and by six weeks you're back in regular shoes.
But the vast majority of my patients never get there. That's the power of regenerative medicine. We're catching these cases before they progress to the point where surgery is the only option.
Ready to explore your options? Call us at 713-785-7881 or request an appointment online. The sooner we identify why your heel pain won't go away, the quicker we can get you back to the activities you've been missing.
What to Expect When You Come to Our Houston Office
When you come in, I'll start by listening. I want to know your story—how long you've been dealing with this, what you've already tried, what your goals are. Are you trying to get back to running? Stand at work without pain? Just walk your dog around the block comfortably? Understanding your goals helps me recommend the right treatment approach.
Then I'll examine your foot and watch you walk. I'm looking at how your foot moves, where the pressure points are, how tight your calf muscles are. Sometimes I'll order an X-ray if we haven't ruled out a stress fracture or significant heel spur. If needed, I might use diagnostic ultrasound to look at the plantar fascia thickness and assess the tissue damage. This tells me whether we're dealing with acute inflammation or chronic degenerative changes—that distinction matters for treatment planning.
Based on what I find, we'll talk through your options. If you've been dealing with this for months and conservative care hasn't worked, we'll likely discuss the combined PRP and shockwave protocol. I'll show you exactly what the treatments involve, what the timeline looks like, and answer all your questions about cost and recovery. If you're ready to move forward, we can often start shockwave therapy that same day or schedule your PRP injection for later that week.
I want you to leave the office with a clear plan and realistic expectations. PRP isn't magic—it's science. It works by restarting your body's own healing process, and that takes time. But for people who've been suffering with chronic heel pain for months or years, 2-4 weeks to start feeling better and 3-6 months for full recovery is absolutely worth it compared to living with this pain indefinitely.
