PAIN+ CPN

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Doctor, I have plantar fasciitis. What treatments can reduce my pain?

There are several different treatments that have been shown to reduce pain due to plantar fasciitis for some people.

What is the evidence?

SUMMARY OF FINDINGS

Different treatments vs control (placebo, sham treatment or no treatment)

OutcomeNo. of peopleEffectQuality of Evidence
Short-term pain (1 to 6 weeks after treatment)*


Botulinum toxin161large reduction in painLow
Micronized dehydrated human amnion/chorion membrane injection175large reduction in painLow
Dry needling215large reduction in painLow
Low-level laser therapy231large reduction in painModerate
Low-dye taping213large reduction in painLow
Myofascial releases101large reduction in painLow
Platelet-rich plasma injection110large reduction in painLow
Radiofrequency87large reduction in painLow
Stretching112large reduction in painLow
Medium-term pain (6 to 12 weeks after treatment)**


Extracorporeal shock wave therapy1,432large reduction in painModerate
Long-term pain (longer than 12 weeks after treatment)***


Extracorporeal shock wave therapy96large reduction in painModerate

*treatments that were not found to reduce pain: acupuncture, corticosteroid injection, extracorporeal shock wave therapy, orthosis, therapeutic ultrasound

**treatments that were not found to reduce pain: orthosis, radiofrequency, tension night splint

***treatments that were not found to reduce pain: platelet-rich plasma injection

Note: results for comparison of one treatment vs another treatment are not reported here


What kind of study was this?

This was a systematic review of 236 randomized controlled trials published up to September 2022.

Who? This review included15,401 adults (average age 25 to 60 years) who had plantar fasciitis (duration not reported).

What? The reviewers included studies that compared a treatment vs control or vs another treatment for plantar fasciitis.

Treatment/Intervention

vs

Control (Placebo/sham treatment/no treatment)

Acupuncture, Botulinum toxin, Dry cupping, Dry needling, Extracorporeal shock wave therapy, Heat, Injections (multiple different types of liquids or drugs), Low-dye taping, Low-level laser therapy, Neuromuscular electrical stimulation, Non-steroidal anti-inflammatory drugs, Orthoses/insoles, Ozone injection, Platelet-rich plasma/blood injection, Physical therapy, Radiofrequency/radiation therapy, Surgery, Tension night splint, Therapeutic ultrasound



Placebo: A pill/needle/lotion containing an inactive substance that has no effect on the outcome. Sometimes, it is referred to as a "sugar pill."



Why was this research done?

Plantar fasciitis is inflammation in the thick band of tissue that runs from the heel bone to the toes along the bottom of the foot. It is a common cause of heel pain that often resolves on its own, but can cause prolonged, disabling pain for some people. The reviewers wanted to know if various treatments are effective in reducing pain due to plantar fasciitis. They found that multiple treatments seem to reduce pain for some people, but the quality of evidence is low for most of them. Only low-level laser therapy had moderate evidence to support that it reduces pain in the short-term and only extracorporeal shock wave therapy had moderate evidence that it reduces pain long-term. Major concerns about this review include the very small size of most of the trials and the wide variation in how the treatments were applied between studies.

This Evidence Summary is based on the following article:

Guimaraes JS, Arcanjo FL, Leporace G, et al. Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis. Clin Rehabil. 2022 Dec 26:2692155221143865. doi: 10.1177/02692155221143865. PubMed

Published: Tuesday, January 31, 2023


Please note that the information contained herein is not to be interpreted as an alternative to medical advice from a professional healthcare provider. If you have any questions about any medical matter, you should consult your professional healthcare providers, and should never delay seeking medical advice, disregard medical advice or discontinue medication based on information provided here.