The effectiveness of conservative, non-pharmacological treatment, of plantar heel pain: A systematic review with meta-analysis

BackgroundPlantar heel pain (PHP) is common. Foot orthoses are often applied as treatment for PHP, even though there is little evidence to support this.ObjectiveTo investigate the effects of different orthoses on pain, function and self-reported recovery in patients with PHP and compare them with other conservative interventions.DesignSystematic review and meta-analysis.Data sourcesA systematic literature search was conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL and Google Scholar up to January 2017.Eligibility criteria for selecting studiesRandomised controlled trials comparing foot orthoses with a control (defined as no intervention, sham or other type of conservative treatment) reporting on pain, function or self-reported recovery in patients with PHP.ResultsTwenty studies investigating eight different types of foot orthoses were included in the review. Most studies were of high quality. Pooled data from six studies showed no difference between prefabricated orthoses and sham orthoses for pain at short term (mean difference (MD) of 0.26 (95% CI −0.09 to 0.60)). No difference was found between sham orthoses and custom orthoses for pain at short term (MD 0.22 (95% CI −0.05 to 0.50)), nor was there a difference between prefabricated orthoses and custom orthoses for pain at short term (MD 0.03 (95% CI −0.15 to 0.22)). For the majority of other interventions, no significant differences were found.ConclusionsFoot orthoses are not superior for improving pain and function compared with sham or other conservative treatment in patients with PHP.PROSPERO registration numberCRD42015029659.

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FRI0062 Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis

10.1136/annrheumdis-2018-eular.2292 ◽

2018 ◽

Author(s):

G. Whittaker ◽

S.E. Munteanu ◽

H.B. Menz ◽

D.R. Bonanno ◽

J.M. Gerrard ◽

...

Keyword(s):

Systematic Review ◽

Corticosteroid Injection ◽

Meta Analysis ◽

Heel Pain ◽

Plantar Heel Pain

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Acupuncture and dry needling for plantar heel pain: a systematic review and meta-analysis

10.26226/morressier.5ab3c87fa874c60026558c28 ◽

2018 ◽

Author(s):

Seunghoon Lee

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Heel Pain ◽

Dry Needling ◽

Plantar Heel Pain

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The Effectiveness of Combined Shockwave Therapy and Exercise for Plantar Heel Pain: A Systematic Review Protocol

10.31236/osf.io/uezfw ◽

2020 ◽

Author(s):

Ian Burton

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Heel Pain ◽

Controlled Trials ◽

Cochrane Central Register ◽

Systematic Review Methodology ◽

Treatment Protocols ◽

Shockwave Therapy ◽

Plantar Heel Pain ◽

Wide Range

Review Objective: To synthesize the best available evidence on the effectiveness of interventions that have used a combination of extracorporeal shockwave therapy and any type of exercise to treat plantar heel pain compared to any other treatment intervention. Introduction: Recent evidence suggests combining shockwave therapy and exercise may be more effective than other treatments for plantar heel pain. However, no systematic reviews have been conducted on the topic and optimal treatment protocols and clinical recommendations are lacking.Inclusion criteria: Randomised controlled trials assessing the effectiveness of combined shockwave therapy and exercise for plantar heel pain in adults will be included. Methods: The authors will search for a wide range of sources to find both published and unpublished studies via EBSCOhost, including, but not limited to, MEDLINE, SPORTDiscus, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and Allied and Complementary Medicine Database (AMED). Studies published in a language other than English will only be considered if a translation is available. The JBI systematic review methodology will be followed when conducting the review. Data synthesis will be conducted using meta-analysis or narrative synthesis, where appropriate. Systematic review registration number: CRD42020213286

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Foot orthoses for plantar heel pain: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2016-097355 ◽

2017 ◽

Vol 52 (5) ◽

pp. 322-328 ◽

Cited By ~ 31

Author(s):

Glen A Whittaker ◽

Shannon E Munteanu ◽

Hylton B Menz ◽

Jade M Tan ◽

Chantel L Rabusin ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Heel Pain ◽

Cochrane Library ◽

Foot Orthoses ◽

Medium Term ◽

Eligibility Criteria ◽

Plantar Heel Pain ◽

Moderate Quality ◽

Quality Evidence

ObjectiveTo investigate the effectiveness of foot orthoses for pain and function in adults with plantar heel pain.DesignSystematic review and meta-analysis. The primary outcome was pain or function categorised by duration of follow-up as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks).Data sourcesMedline, CINAHL, SPORTDiscus, Embase and the Cochrane Library from inception to June 2017.Eligibility criteria for selecting studiesStudies must have used a randomised parallel-group design and evaluated foot orthoses for plantar heel pain. At least one outcome measure for pain or function must have been reported.ResultsA total of 19 trials (1660 participants) were included. In the short term, there was very low-quality evidence that foot orthoses do not reduce pain or improve function. In the medium term, there was moderate-quality evidence that foot orthoses were more effective than sham foot orthoses at reducing pain (standardised mean difference −0.27 (−0.48 to −0.06)). There was no improvement in function in the medium term. In the longer term, there was very low-quality evidence that foot orthoses do not reduce pain or improve function. A comparison of customised and prefabricated foot orthoses showed no difference at any time point.ConclusionThere is moderate-quality evidence that foot orthoses are effective at reducing pain in the medium term, however it is uncertain whether this is a clinically important change.

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Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-098998 ◽

2018 ◽

Vol 53 (3) ◽

pp. 182-194 ◽

Cited By ~ 19

Author(s):

Opeyemi O Babatunde ◽

Amardeep Legha ◽

Chris Littlewood ◽

Linda S Chesterton ◽

Martin J Thomas ◽

...

Keyword(s):

Systematic Review ◽

Comparative Effectiveness ◽

Meta Analysis ◽

Treatment Options ◽

Heel Pain ◽

Medium Term ◽

Sham Control ◽

Short Term ◽

Plantar Heel Pain

ObjectiveTo evaluate the comparative effectiveness of current treatment options for plantar heel pain (PHP).DesignSystematic review and network meta-analysis (NMA).Data sourcesMedline, EMBASE, CINAHL, AMED, PEDro, Cochrane Database, Web of Science and WHO Clinical Trials Platform were searched from their inception until January 2018.Study selectionRandomised controlled trials (RCTs) of adults with PHP investigating common treatments (ie, corticosteroid injection, non-steroidal anti-inflammatory drugs, therapeutic exercise, orthoses and/or extracorporeal shockwave therapy (ESWT)) compared with each other or a no treatment, placebo/sham control.Data extraction and analysisData were extracted and checked for accuracy and completeness by pairs of reviewers. Primary outcomes were pain and function. Comparative treatment effects were analysed by random effects NMA in the short term, medium term and long term. Relative ranking of treatments was assessed by surface under the cumulative ranking probabilities (0–100 scale).ResultsThirty-one RCTs (total n=2450 patients) were included. There was no evidence of inconsistency detected between direct and indirect treatment comparisons in the networks, but sparse data led to frequently wide CIs. Available evidence does not suggest that any of the commonly used treatments for the management of PHP are better than any other, although corticosteroid injections, alone or in combination with exercise, and ESWT were ranked most likely to be effective for the management of short-term, medium-term and long-term pain or function; placebo/sham/control appeared least likely to be effective; and exercise appeared to only be beneficial for long-term pain or function.ConclusionsCurrent evidence is equivocal regarding which treatment is the most effective for the management of PHP. Given limited understanding of long-term effects, there is need for large, methodologically robust multicentre RCTs investigating and directly comparing commonly used treatments for the management of PHP.PROSPERO registration numberCRD42016046963.

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