INTRODUCTION: The purpose of this study was to evaluate adjusting of the foot with stretching versus orthotics to determine the effectiveness of each in subjects with chronic plantar fasciitis. METHODS: DESIGN: A prospective, randomized, blinded, controlled clinical trial. SETTING: University of Surrey Chiropractic Clinic, Guildford, Surrey. PARTICIPANTS: 20 subjects between 18 and 60 years old presented with chronic plantar fasciitis. They were randomly allocated to 2 groups of 10. INTERVENTIONS: All 10 subjects (6 male and 4 female with mean age 44.1) in group 1 received chiropractic adjustments (manipulation) of the foot and ankle and stretching exercises twice a week for 4 weeks and at 1-month follow-up. All 10 subjects (7 male and 3 female with mean age 40.6) in group 2 received a pair of orthotics and were required to keep them in their shoes for a total of 8 weeks. Main outcome measurements: The subjective measurements included Numerical Pain Rating Scale 101, the first-step pain form, and the effect of heel pain on 3 types of activities form (leisure, work, and sport). The objective measurements included algometer readings. The measurements for all 20 subjects were taken at baseline, after interventions 5 and 9, and at 1 month after intervention 9. RESUTLS: Homogeneity was found for intra-group comparison (improvement) with both group 1 (manipulation and stretch) and group 2 (orthotics) with significant differences observed on pain scale worst (G1 p = 0.000 and G2 p = 0.026), first-step pain (G1 p = 0.000 and G2 p = 0.000), heel pain during leisure (G1 p = 0.008 and G2 p = 0.16), and algometer readings (G1 p = 0.004 and G2 p = 0.000). For the inter-group measurements, the only reading that revealed significant difference was the pain scale worst measurement on 15, with group 1 (manipulation and stretching) being superior (earlier) to group 2 (orthotics). CONCLUSION: With the small sample size and methodological limitations of this trial, no firm conclusions can be drawn; the data regarding effectiveness should be interpreted with caution. Nevertheless, within the limits of this trial, both treatments appeared useful when used individually for treatment of common plantar fasciitis and further research is supported.

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