Dry Needling &

Plantar Fasciitis
Shaela Crespin, Talisha Dawes
PICO Question:

In patients 40-60 years old with plantar fasciitis, will the

implementation of dry needling decrease pain more effectively than a
treatment plan without?

Effectiveness of trigger point dry needling for plantar heel pain: a

meta-analysis of seven randomized controlled trials

A systematic review for randomized controlled trials that assessed the effects of dry
needling by: Chunhi He and Hua Ma.
 Study Purpose & Article

● To assess and evaluate the

effectiveness of managing plantar
heel pain due to plantar fasciitis
with the use of myofascial trigger
point (MTrP) dry needling.

Effectiveness of trigger point dry

●

needling for plantar heel pain: a

Background Literature
Plantar fasciitis is inflammation caused by stretching and tearing
of the plantar fascia. It’s the most common type of heel pain and is
felt over the medial tubercle of the calcaneus. Pain is commonly
felt when first standing in the morning and after weight bearing
for long periods of time. Risk factors include age, foot mechanics,
obesity, and activities that place high stress on your plantar fascia.

A popular form of treatment is a steroid injection in the medial

side of the calcaneus for short term pain relief. However, this
treatment has a risk of causing plantar fascia rupture.

Dry needling releases adenosine hormone that blocks pain

receptors and decreases the electrical activity in the muscle with
very little side effects for long term/chronic conditions.
Study & Sample
Type of Study:
● Meta-analysis performed using Stata 12.0 of 7 randomized controlled trials.
● Publications inclusion criteria were study design (randomized controlled trial), population
(adult patients aged 18+ who were previously diagnosed plantar fasciitis and heel pain),
intervention (dry needling of MTrPs), control (placebo or other treatment avoiding dry
needling), and outcome measure (changes in Visual Analog Scale (VAS) score).
● Out of the 1,941 publications that were initially yielded, seven RCTs (randomized
controlled trials) met the complete inclusion criteria and were incorporated.

Sample:
● Between all seven of the included RCTs, there were from 417 participants.
● 175 participants were male and 242 participants were female.
● All included RCTs used a VAS to measure the intensity of pain, with the success for pain
defined as a minimum decrease of 50% in VAS scores.
Outcome Measures
● All of the included studies reported data on changes in VAS scores.
● VAS scores were evaluated at 1 month, 6 months, and 12 months.
○ All of which expressed a significant reduction in VAS scores.
○ VAS scores had a much greater reduction with MTrP needling than in the control group.
○ Morning pain and active pain VAS scores were significantly decreased in the MTrP group.

● Three studies reported immediate

adverse events related to needle site
pain, but a decrease in pain overtime.
Intervention

- All seven studies were published between 2011 and 2017.

- They were questioning if trigger point needling is an effective treatment for patients with plantar
fasciitis.
- These studies were conducted in People’s Republic of China (Zhang, Li, Wang), Australia
(Catchett), Iran (Eftekharsadat), and Thailand (Kumnerddee).
- Each study used dry needling for 6 weeks in the calf and heel regions.

Use of dry needling to decrease pain and muscle guarding and to increase ROM
Results

- The VAS scores significantly dropped when using dry needling on plantar fasciitis
patients.
- P<0.001 when comparing VAS scores between dry needling and other treatments;
meaning it was very statistically significant
- From these experiments, we now know this technique works better than all the others
that were previously used for trigger point release and plantar fasciitis.
Clinical Bottom Line

- Dry needling can decrease pain in patients

with plantar fasciitis more efficiently than
traditional methods of treatment.
- Lasts longer than the current most
popular treatment for plantar fasciitis
(steroid shot)
- Decreases muscle guarding
- Improves ROM

Study Limitations: small sample size.

Works Cited
He, C., & Ma, H. (2017). Effectiveness of trigger point dry needling for plantar heel pain: A meta-analysis of seven randomized
controlled trials. Journal of Pain Research, Volume 10, 1933–1942.

Mayo Foundation for Medical Education and Research. (2019, December 11). Plantar fasciitis. Mayo Clinic. Retrieved November
20, 2021, from https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846.