Efficacy of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis: a systematic review and meta-analysis

Abstract

ObjectiveTo investigate the effects of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis.DesignSystematic review of randomised controlled trials (RCTs).Data sourcesAMED, MEDLINE, PEDro, Cochrane, SPORTDiscus, CINAHL, EMBASE and PsycINFO without language or date restrictions up to 3 February 2023.Eligibility criteriaRCTs that evaluated the efficacy of any pharmacological and non-pharmacological therapies compared with control (placebo, sham, waiting list or no intervention) on pain intensity and disability in people with plantar fasciitis. Two reviewers independently screened eligible trials, extracted data, assessed the methodological quality of included trials and assessed the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations framework. Mean differences (MDs) with 95% CIs were reported.ResultsSeventeen different therapies investigated in 28 trials were included in the quantitative analysis. For non-pharmacological therapies, moderate certainty evidence showed short-term effects of customised orthoses on pain intensity when compared with control (MD of −12.0 points (95% CI −17.1 to −7.0) on a 0–100 scale). Low certainty evidence showed short-term effects of taping on pain intensity (−21.3 (95% CI −38.6 to −4.0)). Long-term effects and effects on disability are still uncertain. For pharmacological therapies, low to very low quality evidence from few trials with small samples was inconclusive and supports that high-quality trials are needed.ConclusionsModerate-quality and low-quality evidence demonstrates customised orthoses and taping, respectively, reduce pain intensity in the short term in patients with plantar fasciitis.PROSPERO registration numberCRD42021224416.

Deep peroneal nerve block may be a new treatment way for plantar fasciitis

“…Focused extracorporeal shock wave therapy has long been considered the best treatment for plantar fasciitis, compared with corticosteroid injection, focused extracorporeal shock wave has many advantages such as non-invasive, low risk and fewer complications. In addition, extracorporeal shock wave therapy can reshape the tissue structure of plantar fascia, but it also has the disadvantages of long treatment cycle and high cost, and some patients are also accompanied by a certain degree of pain during the treatment [9] . Some scholars believe that foot orthotics and night splints can relieve the symptoms of plantar fasciitis to a certain extent, but additional orthopedic devices may affect the normal activities of patients [18] .…”

“…Its exact treatment regimen, such a pulse number, energy number, shock wave frequency, focusing method, have not been widely con rmed by various clinical trials [8,9] . The current treatment methods mainly focus on the local in ammatory changes of the plantar fascia, and few studies have focused on the mechanical changes of the plantar fascia.…”

Is radial extracorporeal shock wave therapy (rESWT), sham-rESWT or a standardised exercise programme in combination with advice plus customised foot orthoses more effective than advice plus customised foot orthoses alone in the treatment of plantar fasciopathy? A double-blind, randomised, sham-controlled trial

“…ESWT with placebo showing no superior effects of shock wave therapy. 14 In contrast to previous trials 21 22 36 the physiotherapist in the present study conducted multiple sessions with patients in the high-load strength training group to provide guidance and ensure adherence, as the ability to attain sufficient progressive loading can influence treatment outcomes. 37 Most patients in the exercise group (74%) completed according to the per protocol, though the physiotherapist made individualised adjustments that deviated from the planned regimen.…”

A randomized study comparing the effect of platelet-rich plasma and platelet-poor plasma for the treatment of plantar fasciitis

“…Plantar fasciitis is an inflammatory and degenerative condition of the proximal plantar aponeurosis of the calcaneus (Rabadi et al, 2022), in which a proliferation of fibroblasts in the inflammation site is seen. It affects more ageing and runners' population (Lopez-Lopez et al, 2021) The most common treatment to control the inflammation is to treat it with anti-inflammatory and analgesic drugs (Lourenço et al, 2023), use dry needling for myofascial trigger points (Silva, Sousa & Rebêlo, 2022) and use orthopaedic insoles (De Souza, 2017), heels, splints and night orthotics. Physiotherapy has also been shown to reduce inflammation and pain in more than 90% of patients (Cardenuto, 2014;De Souza, 2017).…”