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.…”

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).…”

The Effectiveness of Customised 3D-Printed Insoles on Perceived Pain, Comfort, and Completion Time Among Frequent Park Runners: Study Protocol for a Pragmatic Randomised Controlled Trial (The ZOLES RCT)

“…Many studies have an observational or non-randomised design [28], while other studies compare custom orthotics with sham or generic insoles [29][30][31], which may carry their own therapeutic properties, potentially diluting the observed benefits of the customised versions. To date, however, the most compelling evidence of orthotic interventions includes the effect on specific diagnoses such as plantar fasciitis [32], and Achilles tendinopathy with moderate-to-low certainty of short-term pain reductions [33]. These conditions, while common among runners [10], are often alleviated using a comprehensive treatment approach, in which the effect of the orthotics is often assessed as an adjunct part of the treatment including and patient education in combination with other interventions like physical therapy and rehab exercises [33,34], and corticosteroid injections [34].…”