Efficacy of electro-acupuncture in chronic plantar fasciitis: a randomized controlled trial (2012)
The objective was to compare the efficacy of electroacupuncture plus conventional treatments with conventional treatments alone in chronic plantar fasciitis. We used a prospective randomized controlled trial in a rehabilitation medicine outpatient department, Phramongkutklao hospital, Bangkok, Thailand.
Methods: Subjects were chronic plantar fasciitis patients who failed conservative treatment with onset of at least 6 months. Thirty subjects, aged 53.1±9.2 years, were randomly assigned into the acupuncture and the control groups. Subjects in the control group received 6 weeks of conventional treatments including stretching exercise program, shoe modification and medication. Subjects in the acupuncture group also received conventional treatments plus 10 sessions of electroacupuncture twice a week. Outcomes were measured by 10-cm visual analog scale (VAS) and Foot function index (FFI) at baseline, at the end of treatment protocol and at 6 weeks after treatment completed.
Results: At the end of treatment protocol, VAS decreased from 6.00±1.69 to 1.89±1.59 and 6.27±2.34 to 5.40±2.26 while FFI decreased from 5.20±1.21 to 1.30±1.27 and 4.98±1.91 to 4.66±2.24 in the acupuncture and control groups, respectively. Both VAS and FFI significantly decreased more in acupuncture group than those found in the control group (P<0.001). Six subjects in the control group dropped out and requested for acupuncture after treatment ended. At 6 weeks after treatment, VAS decreased to 1.40±1.80 and 2.20±1.66 whereas FFI decreased to 1.00±1.38 and 1.83±1.60 in the acupuncture and in the control groups, respectively. Only VAS at the first step showed more significant reduction in the acupuncture than that in the control group (P=0.025). Other outcomes did not show significant differences between groups at 6 weeks after treatment completed. There was no significant difference of analgesic intake between groups at baseline, at the end and at 6 weeks after treatment completed.
Conclusions: Electroacupuncture plus conventional treatments was more effective than conventional treatments alone in chronic planar fasciitis. The efficacy lasted for at least 6 weeks.
Acupuncture treatment for plantar fasciitis: a randomized controlled trial with six months follow-up (2011)
Plantar fasciitis is a common cause of heel pain. It has been suggested that some acupoints have a specific effect on heel pain. The aim of this study was to determine the efficacy and specificity of acupuncture treatment for plantar fasciitis.
Methods: Subjects were randomly assigned to the treatment group (n = 28) or control group (n = 25). The treatment group received needling at the acupoint PC 7, which is purported to have a specific effect for heel pain. The control group received needling at the acupoint Hegu (LI 4), which has analgesic properties. Treatment was administered five times a week for 2 weeks, with an identical method of manual needling applied to the two acupoints.
Results: The primary outcome measure was morning pain on a 100-point visual analog scale (VAS) at one month post-treatment. Secondary outcome measures included a VAS for activity pain, overall pain rating as well as pressure pain threshold using algometry. Significant differences in reduction in pain scores, favoring the treatment group, were seen at one month for morning pain (22.6 ± 4.0 versus 12.0 ± 3.0, mean ± SEM), overall pain (20.3 ± 3.7 versus 9.5 ± 3.6) and pressure pain threshold (145.5 ± 32.9 versus -15.5 ± 39.4). No serious adverse event was observed in either group.
Conclusion: The results indicate that acupuncture can provide pain relief to patient with plantar fasciitis, and that PC 7 is a relatively specific acupoint for heel pain.
The effectiveness of acupuncture for plantar heel pain: a systematic review (2012)
INTRODUCTION:Plantar heel pain (PHP) is a common complaint, yet there are no definitive guidelines for its treatment. Acupuncture is increasingly used by podiatrists, and there is a need for evidence to validate this practice. It is acknowledged that PHP and acupuncture are both complex phenomena.
METHOD:A systematic review (PROSPERO no. CRD42012001881) of the effectiveness of acupuncture for PHP is presented. Quality of the studies was assessed by independent assessors with reference to Quality Index (QI), 'STandards for Reporting Interventions in Controlled Trials of Acupuncture' (STRICTA) and 'CONsolidated Standards Of Reporting Trials' (CONSORT) criteria. Pooling of data, or even close comparison of studies, was not performed.
RESULTS:Five randomised controlled trials and three non-randomised comparative studies were included. High quality studies report significant benefits. In one, acupuncture was associated with significant improvement in pain and function when combined with standard treatment (including non-steroidal anti-inflammatory drugs). In another, acupuncture point PC7 improved pain and pressure pain threshold significantly more than LI4. Other papers were of lower quality but suggest benefits from other acupuncture approaches.
CONCLUSIONS:There is evidence supporting the effectiveness of acupuncture for PHP. This is comparable to the evidence available for conventionally used interventions, such as stretching, night splints or dexamethasone. Therefore acupuncture should be considered in recommendations for the management of patients with PHP. Future research should recognise the complexity of PHP, of acupuncture and of the relationship between them, to explore the optimum use and integration of this approach. There is a need for more uniformity in carrying out and reporting such work and the use of STRICTA is recommended.