One hundred fifty six adults with chronic plantar fasciitis were randomized to receive ultrasound-guided corticosteroid injection (n=76) or radial extracorporeal shock wave therapy (rESWT; n=80). The corticosteroid group received 2 mL methylprednisolone acetate (40 mg/mL) + 2 mL 2% lidocaine delivered under ultrasound guidance, while the rESWT group received 2000 impulses at 2.5 bars and 15 Hz weekly for three consecutive weeks. The primary outcome of interest was pain, assessed using the Visual Analogue Scale (VAS) at the first step in the morning, at rest, and during ADLs. Secondary outcomes included the FAAM-ADL and FAAM-Sports subscales and ultrasound-measured plantar fascia thickness. Outcomes were measured at baseline, 4 weeks, and 8 weeks. Overall, the results revealed that corticosteroid injection produced greater reductions in pain, better functional improvement, and greater reduction in plantar fascia thickness at both 4 and 8 weeks compared with rESWT. In conclusion, early outcomes favored corticosteroid injection as the more effective modality for short-term symptom relief in plantar fasciitis.