Most of the complications related to these interventions were analyzed. The side effect of the steroid varies based on the body site where it is injected; in the joint, muscle or spine. A review done by Hynes and Kavanagh, 2022 reveals that extra-articular steroid injection reports minor and major events in 0.81% and 0.5 to 8%, respectively while the injection in shoulder joints presents the major reaction in 18.1% [68 (link)]. As in our study, the injection was locally applied to the heel region; there were few chances of side effects like pain and discomfort for a few days, temporary bursitis, and flushing of the face for a few hours. The systemic side effects of local steroid injection are poorly understood and not well recognized, hence clinically insignificant [69 (link)]. Although there is a rise in blood glucose in diabetic participants, it is considered clinically insignificant [70 , 71 ]. Plantar fascia rupture and heel fat pad atrophy are associated with local steroid injections in the long term which is around only 2.4–6.7% [72 (link)]. The steroid injection may develop temporary or permanent neural dysfunction leading to economic or social disabilities [73 (link)]. Hypopigmentation and atrophy of the skin may occur [74 , 75 ], which is interestingly re-pigmented with exposure to ultraviolet light after a few months [76 (link), 77 (link)]. Moreover, normal saline injection is considered a very effective modality to treat progressive cutaneous atrophy [78 (link)]. However, there were no such cases in our study. On the other side, PRP treatment is considered a safe and effective approach having very less side effects [33 (link)]. As this study was performed in a highly specialized tertiary hospital, the institution had a well-managed setup to handle in case of any immediate adverse reaction occurred.
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