Abstract
BackgroundPlantar heel pain (plantar fasciitis) is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs) however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain.MethodsWe searched specific electronic databases (MEDLINE, EMBASE, AMED, CINAHL, SPORTDiscus and AMI) in April 2010 to identify randomised and non-randomised trials. We included trials where participants diagnosed with plantar heel pain were treated with dry needling and/or injections (local anaesthetics, steroids, Botulinum toxin A and saline) alone or in combination with acupuncture. Outcome measures that focussed on pain and function were extracted from the data. Trials were assessed for quality using the Quality Index tool.ResultsThree quasi-experimental trials matched the inclusion criteria: two trials found a reduction in pain for the use of trigger point dry needling when combined with acupuncture and the third found a reduction in pain using 1% lidocaine injections when combined with physical therapy. However, the methodological quality of the three trials was poor, with Quality Index scores ranging form 7 to 12 out of a possible score of 27. A meta-analysis was not conducted because substantial heterogeneity was present between trials.ConclusionsThere is limited evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. However, the poor quality and heterogeneous nature of the included studies precludes definitive conclusions being made. Importantly, this review highlights the need for future trials to use rigorous randomised controlled methodology with measures such as blinding to reduce bias. We also recommend that such trials adhere to the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) to ensure transparency.
Highlights
Plantar heel pain is one of the most common musculoskeletal pathologies of the foot
We aimed to systematically review the literature evaluating the effectiveness of dry needling and/or injections of myofascial trigger points (MTrPs) associated with plantar heel pain
Types of studies All clinical trials included in this review were obtained from peer-reviewed journals investigating the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain
Summary
Plantar heel pain (plantar fasciitis) is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs) the evidence for its effectiveness is uncertain. We aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. Plantar heel pain is generally accepted to predominantly affect middle aged as well as older adults. Plantar heel pain affects older adults, some other groups are vulnerable. It is common in the athletic population, being estimated to contribute to 25% of all foot injuries related to running [5]. Plantar heel pain has been shown to have an impact on health-related quality of life. Individuals with chronic plantar heel pain experience social isolation; have a poor perception of their health status; are severely limited in their ability to undertake physical activities and lack the energy to undertake daily tasks [6]
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