Plantar fasciitis is usually treated nonoperatively, but some patients continue to have heel pain despite months of stretching, orthotics, immobilization, and therapy. For these recalcitrant cases, options like repeat injections, shockwave, or surgery carry tradeoffs.
Why BMAC?
Concentrated bone marrow aspirate provides a cell- and growth-factor rich biologic environment aimed at promoting tissue repair rather than just reducing inflammation, potentially “resetting” chronic degenerative pain.
Study design:
Case series of patients with ≥12 months of symptoms despite extensive conservative care. Iliac crest bone marrow was aspirated, concentrated, and ~6 mL injected at the point of maximal plantar fascia tenderness. Patients followed a staged non–weight-bearing to boot protocol.
Results:
*19 patients (mean age 52.6; symptoms ~2.5 years)
* Mean VAS improved from 7.5 pre-injection to 2.3 at 6 weeks and 1.1 at 48 weeks
* No donor-site or injection-related complications
* One patient required a repeat PRP+BMAC injection at 1 year with symptom relief
Takeaway:
In this small series, a single BMAC injection led to rapid, durable pain reduction through 48 weeks with an excellent safety profile, suggesting a potential option before surgery in selected patients. Larger controlled studies are needed to compare BMAC with PRP, shockwave, or surgery.
Article: https://link.springer.com/article/10.1007/s00264-025-06722-x
