Effects of Dry Needling on Heel Pain and Function in Patients with Plantar Fasciitis: A Randomized Controlled Trial
DOI:
https://doi.org/10.66021/pakmcr906Keywords:
Plantar fasciitis, dry needling, heel pain, myofascial trigger points, randomized controlled trialAbstract
Background: Plantar fasciitis (PF) is the most common cause of heel pain, often leading to significant functional limitations. While conventional treatments exist, many patients report persistent symptoms. Dry needling (DN) is increasingly used for myofascial trigger points, but its specific effect on PF remains unclear.
Objective: To determine the effects of dry needling combined with conventional treatment, compared to conventional treatment alone, on heel pain and foot function in patients with plantar fasciitis.
Methods: A single-blind, parallel-group randomized controlled trial was conducted. Forty-six participants (mean age 48.2 ± 7.5 years) with chronic plantar fasciitis (>3 months) were randomly assigned to either a conventional treatment group (control, n=23) or a conventional treatment plus dry needling group (DN group, n=23). The control group received calf stretching, plantar fascia-specific stretching, and ultrasound therapy (10 sessions over 4 weeks). The DN group received the same conventional treatment plus dry needling of the gastrocnemius, soleus, and intrinsic foot muscles (two sessions per week for 4 weeks). Primary outcomes were morning first-step pain (Numerical Pain Rating Scale, NPRS 0-10) and foot function (Foot Function Index – Revised, FFI-R). Assessments were taken at baseline, post-treatment (4 weeks), and 3-month follow-up.
Results: No significant baseline differences existed between groups. At 4 weeks, the DN group showed significantly greater reductions in NPRS scores (mean difference -2.4, 95% CI: -3.1 to -1.7, p<0.001) and FFI-R scores (mean difference -18.4, 95% CI: -25.2 to -11.6, p<0.001) compared to controls. At 3-month follow-up, improvements were maintained in the DN group, with 78% reporting minimal clinically important difference (MCID) for pain vs. 39% in controls. No serious adverse events were reported; transient post-needling soreness occurred in 5 DN participants.
Conclusion: Adding dry needling to conventional treatment produces superior short- and medium-term improvements in heel pain and foot function for patients with chronic plantar fasciitis compared to conventional treatment alone. These results support the inclusion of dry needling in multimodal management of PF.
