BACKGROUND: Plantar heel pain can be managed with dry needling of myofascial trigger points, however there is only poor quality evidence supporting its use. OBJECTIVE: To evaluate the effectiveness of dry needling for plantar heel pain. DESIGN: Parallel group, participant blinded, randomized controlled trial. SETTING: A university health sciences clinic. PATIENTS: Study participants were 84 patients with plantar heel pain of at least one month's duration. INTERVENTION: Participants were randomised to real or sham trigger point dry needling. The intervention consisted of one treatment per week for six weeks. Participants were followed for 12 weeks. MEASUREMENTS: Primary outcome measures included 'first-step pain' measured with a visual analogue scale and foot pain measured with the pain subscale of the Foot Health Status Questionnaire. The primary end-point for predicting the effectiveness of dry needling for plantar heel pain was six weeks. RESULTS: At the primary end-point, significant effects favored real dry needling over sham dry needling for pain (adjusted mean difference: VAS first-step pain -14.4 mm, 95% CI -23.5 to -5.2, p = 0.002; FHSQ foot pain 10.0 points, 95% CI 1.0 to 19.1, p = 0.029), although the between-group difference was lower than the minimal important difference. The number needed to treat at six weeks was 4 (95% CI 2 to 12). The frequency of minor transitory adverse events was significantly greater in the real dry needling group (70 real dry needling appointments (32%) compared with only 1 sham dry needling appointment (< 1%)). LIMITATIONS: It was not possible to blind the therapist. CONCLUSION: Dry needling provided statistically significant improvements in plantar heel pain, but the magnitude of this effect should considered against the frequency of minor transitory adverse events.

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