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)

Outcome	No. of people	Effect	Quality of Evidence
Short-term pain (1 to 6 weeks after treatment)*
Botulinum toxin	161	large reduction in pain	Low
Micronized dehydrated human amnion/chorion membrane injection	175	large reduction in pain	Low
Dry needling	215	large reduction in pain	Low
Low-level laser therapy	231	large reduction in pain	Moderate
Low-dye taping	213	large reduction in pain	Low
Myofascial releases	101	large reduction in pain	Low
Platelet-rich plasma injection	110	large reduction in pain	Low
Radiofrequency	87	large reduction in pain	Low
Stretching	112	large reduction in pain	Low
Medium-term pain (6 to 12 weeks after treatment)**
Extracorporeal shock wave therapy	1,432	large reduction in pain	Moderate
Long-term pain (longer than 12 weeks after treatment)***
Extracorporeal shock wave therapy	96	large reduction in pain	Moderate

*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."

Treatment/Intervention

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.

This Evidence Summary was printed from the PAIN+ CPN website on 2024/11/21.

To view other Evidence Summaries or to register to receive email notifications about new Evidence Summaries, please visit us at https://www.painpluscpn.ca/Articles/EvidenceSummaries