Is Dry Needling Effective for the Management of Plantar Heel Pain or Plantar Fasciitis? An Updated Systematic Review and Meta-analysis

Pain Medicine ◽  
2021 ◽  
Author(s):  
Luis Llurda-Almuzara ◽  
Noé Labata-Lezaun ◽  
Toni Meca-Rivera ◽  
Marcos J Navarro-Santana ◽  
Joshua A Cleland ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Plantar Fasciitis ◽  
Meta Analysis ◽  
Heel Pain ◽  
Risk Of Bias ◽  
Dry Needling ◽  
Level Of Evidence ◽  
Plantar Heel Pain ◽  
Quality Evidence

Abstract Objective Dry needling is commonly used for the management of plantar fasciitis. This meta-analysis evaluated the effects of dry needling over trigger points (TrPs) associated with plantar heel pain on pain intensity and related disability or function. Methods Electronic databases were searched for randomized controlled trials where at least one group received dry needling, not acupuncture, for TrPs associated with plantar heel pain and collected outcomes on pain intensity and related-disability. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool, methodological quality was assessed with PEDro score, and the level of evidence is reported using the GRADE approach. Between-groups mean differences (MD) and standardized mean difference (SMD) were calculated. Results The search identified 297 publications with 6 trials eligible for inclusion. The meta-analysis found low quality evidence that TrP dry needling reduces pain intensity at short term (MD -1.70 points, 95%CI -2.80 to -0.60; SMD -1.28, 95%CI -2.11 to -0.44) and moderate quality evidence for improving pain intensity (MD -1.77 points, 95%CI -2.44 to -1.11; SMD -1.45, 95%CI -2.19 to -0.70) and related-disability (SMD -1.75, 95% CI -2.22 to -1.28) at long-term compared to a comparison group. The RoB of the trials was generally low, but the heterogeneity of the results downgraded the level of evidence. Discussion Moderate to low evidence suggests a positive effect of TrP dry needling for improving pain intensity and pain-related disability in patients with plantar heel pain of musculoskeletal origin at short- and long-term, respectively. Current results should be considered with caution due to the small number of trials.

Effects of Trigger Point Dry Needling for Nontraumatic Shoulder Pain of Musculoskeletal Origin: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Marcos J Navarro-Santana ◽  
Guido F Gómez-Chiguano ◽  
Joshua A Cleland ◽  
Jose L Arias-Buría ◽  
César Fernández-de-las-Peñas ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Pain Intensity ◽  
Shoulder Pain ◽  
Trigger Point ◽  
Meta Analysis ◽  
Dry Needling ◽  
Short Term ◽  
Positive Effects ◽  
Evidence Level ◽  
Quality Evidence

Abstract Objective The purpose of this study was to evaluate the effects of trigger point (TrP) dry needling alone or as an adjunct to other interventions on pain intensity and related disability in nontraumatic shoulder pain. Methods Ten databases were searched from inception to January 2020 for randomized clinical trials in which at least 1 group received TrP dry needling for shoulder pain of musculoskeletal origin with outcomes collected on pain intensity and related disability. Data extraction including participant and therapist details, interventions, blinding strategy, blinding assessment outcomes, and results were extracted by 2 reviewers. The risk of bias (RoB, Cochrane Guidelines), methodological quality (PEDro score), and evidence level (GRADE approach) were assessed. The search identified 551 publications with 6 trials eligible for inclusion. Results There was moderate quality evidence that TrP dry needling reduces shoulder pain intensity with a small effect (MD = −0.49 points, 95% CI = −0.84 to −0.13; SMD = −0.25, 95% CI = −0.42 to −0.09) and low quality evidence that TrP dry needling improves related disability with a large effect (MD = −9.99 points, 95% CI -15.97 to −4.01; SMD = −1.14, 95% CI -1.81 to −0.47) as compared to a comparison group. The effects on pain were only found at short-term. The RoB was generally low, but the heterogenicity of the results downgraded the evidence level. Conclusions Moderate- to low-quality evidence suggests positive effects of TrP dry needling for pain intensity (small effect) and pain-related disability (large effect) in nontraumatic shoulder pain of musculoskeletal origin, mostly at short term. Future clinical trials investigating long-term effects are needed. Impact Dry needling is commonly used for the management of musculoskeletal pain. This is the first meta-analysis to examine the effects of dry needling on nontraumatic shoulder pain.

scholarly journals Effectiveness of Dry Needling for the Management of Plantar Fasciitis: A Review Study

2019 ◽  
Author(s):  
Saman Salehi ◽  
Azadeh Shadmehr ◽  
Gholamreza Olyaei ◽  
Siamak Bashardoust Tajali ◽  
Seyed Mohsen Mir
Keyword(s):  
Plantar Fasciitis ◽  
Heel Pain ◽  
Dry Needling ◽  
High Quality Research ◽  
Randomized Controlled ◽  
Plantar Heel Pain ◽  
Quasi Experimental ◽  
Review Study ◽  
Study Designs

Introduction: Plantar Fasciitis (PF) is an overuse syndrome as it develops over time. It is most frequently seen in both the non-athletic and athletic populations. PF is a multifactorial and self-limiting disorder that several factors are involved in its onset. Many well-established treatments are available for plantar heel pain. The purpose of this review is to determine the effectiveness of dry needling for the management of PF. Materials and Methods: This article is a review study,  in which  we present  the  studies that compare dry needling with other treatments for the management of plantar  heel pain.  We included all of the studies on patients with plantar heel pain and plantar fasciitis that investigated the effects of dry needling. Finally, seven articles were included in this review. The  study  designs  were  randomized  controlled,  quasi-experimental,  and  case-control. The Physiotherapy Evidence-based Database (PED) scale was used to measure the methodological quality of the studies. Results: The PEDro scoring of the articles ranged between 2.10-7.10. The results of this review show that dry needling may be useful in improving the pain of individuals with plantar heel pain and plantar fasciitis. Conclusion: Further high-quality research studies are needed to determine the effectiveness of dry needling in the management of plantar heel pain. Because a variety of protocol treatments of dry needling were used in the studies, we cannot recommend dry needling schedule prescriptions for the management of individuals with plantar heel pain and plantar fasciitis.

Consensus for Dry Needling for Plantar Heel Pain (Plantar Fasciitis): A Modified Delphi Study

2011 ◽  
Vol 29 (3) ◽  
pp. 193-202 ◽  
Author(s):  
Matthew P Cotchett ◽  
Karl B Landorf ◽  
Shannon E Munteanu ◽  
Anita M Raspovic
Keyword(s):  
Delphi Study ◽  
Plantar Fasciitis ◽  
Heel Pain ◽  
Dry Needling ◽  
Plantar Heel Pain ◽  
Modified Delphi

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

2017 ◽  
Vol 52 (5) ◽  
pp. 322-328 ◽  
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.

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

2018 ◽  
Vol 53 (3) ◽  
pp. 182-194 ◽  
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.

Outcome of Corticosteroid Injections, Extracorporeal Shock Wave Therapy, and Radiofrequency Thermal Lesioning for Chronic Plantar Fasciitis

2020 ◽  
pp. 107110072094946
Author(s):  
Tunay Erden ◽  
Berkin Toker ◽  
Omer Cengiz ◽  
Bugra Ince ◽  
Seyda Asci ◽  
...  
Keyword(s):  
Shock Wave ◽  
Pain Intensity ◽  
Plantar Fasciitis ◽  
Corticosteroid Injection ◽  
Extracorporeal Shock Wave Therapy ◽  
Heel Pain ◽  
Symptom Duration ◽  
Shock Wave Therapy ◽  
Plantar Heel Pain ◽  
Extracorporeal Shock Wave

Background: Chronic heel pain with plantar fasciitis is relatively common and can affect adults of all ages regardless of an active or sedentary lifestyle. The purpose of the present study was to evaluate the effectiveness of corticosteroid injection (CSI), extracorporeal shock wave therapy (ESWT), and radiofrequency thermal lesioning (RTL) treatments in chronic plantar heel pain that has been unresponsive to other conservative treatments. Methods: We retrospectively analyzed the results of 217 patients treated with CSI ( n = 73), ESWT ( n = 75), and RTL ( n = 69). The treatment efficacy and pain intensity, as measured using the visual analog scale, were recorded and compared at the 6-month follow-up. Results: Pain intensity decreased significantly in all patients. However, it decreased significantly more in the CSI and RTL groups than in the ESWT group ( P < .001). Age, sex, body mass index, calcaneal spur presence, and symptom duration were similar among 3 groups ( P > .05). No complications were noted after the CSI, ESWT, or RTL sessions. Conclusion: CSI, ESWT, and RTL successfully treated chronic plantar heel pain that did not respond to other conservative treatments; however, CSI and RTL yielded better therapeutic outcomes. Level of Evidence: Level III, retrospective comparative study.

Effectiveness of Ultrasound-Guided Percutaneous Electrolysis for Musculoskeletal Pain: A Systematic Review and Meta-Analysis

Pain Medicine ◽  
2020 ◽  
Author(s):  
Guido F Gómez-Chiguano ◽  
Marcos J Navarro-Santana ◽  
Joshua A Cleland ◽  
Jose L Arias-Buría ◽  
César Fernández-de-las-Peñas ◽  
...  
Keyword(s):  
Size Effect ◽  
Pain Intensity ◽  
Musculoskeletal Pain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Ultrasound Guided ◽  
Short Term ◽  
Large Size ◽  
Large Size Effect

Abstract Objective To evaluate the effects of ultrasound-guided percutaneous electrolysis alone or as an adjunct to other interventions on pain and pain-related disability for musculoskeletal pain conditions. Databases and Data Treatment Search of MEDLINE database, Allied and Complementary Medicine Database, EMBASE database, Cumulative Index to Nursing & Allied Health Literature database, EBSCO database, PubMed database, Physiotherapy Evidence Database, Cochrane Library database, Scopus database, and Web of Science database. Randomized controlled trials in which at least one group received ultrasound-guided percutaneous electrolysis for treatment of musculoskeletal pain. To be eligible, studies had to include humans and collect outcomes on pain intensity and pain-related disability for musculoskeletal pain syndromes. Data were extracted by two reviewers. The risk of bias was assessed by the Cochrane Guidelines and the quality of evidence was reported using the Grading of Recommendations Assessment, Development and Evaluation approach. Standardized mean differences (SMDs) and random effects were calculated. Results Ten studies were included. The meta-analysis found that ultrasound-guided percutaneous electrolysis reduced the mean pain intensity by –2.06 (95% confidence interval [CI], –2.69 to –1.42) and the pain intensity as assessed with a visual analog scale or a numeric pain rating scale with a large size effect (SMD = –1.15; 95% CI, –1.48 to –0.81) and also improved pain-related disability with a large size effect (SMD = 0.95; 95% CI, 0.73–1.18) as compared with comparison groups. No differences in effect sizes were found among the short-term, midterm, and long-term follow-ups. The risk of bias was generally low, but the heterogeneity of the overall result downgraded the evidence level. Trials included heterogeneous musculoskeletal pain conditions and short-term, midterm, and long-term follow-ups. Conclusion Moderate evidence suggests positive effects of ultrasound-guided percutaneous electrolysis for pain and pain-related disability in musculoskeletal pain conditions relative to a comparison group in the short term, midterm, and long term.

scholarly journals Effects of Trigger Point Dry Needling for the Management of Knee Pain Syndromes: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (7) ◽  
pp. 2044 ◽  
Author(s):  
Youssef Rahou-El-Bachiri ◽  
Marcos J. Navarro-Santana ◽  
Guido F Gómez‐Chiguano ◽  
Joshua Cleland ◽  
Ibai López‐de‐Uralde‐ Villanueva ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Trigger Point ◽  
Meta Analysis ◽  
Patellofemoral Pain ◽  
Risk Of Bias ◽  
Dry Needling ◽  
Short Term ◽  
Post Surgery

Background: To evaluate the effect of trigger point dry needling alone or as an adjunct with other interventions on pain and related disability in people with knee pain. Methods: Several electronic databases were searched for randomized controlled trials where at least one group received dry needling for knee pain. Studies had to include human subjects and collect outcomes on pain and pain-related disability in musculoskeletal knee pain. Data were extracted by two reviewers. The risk of bias was assessed by the Cochrane Guidelines, methodological quality was assessed with the Physiotherapy Evidence Database (PEDro) score, and the quality of evidence by using the GRADE approach. Standardized mean differences (SMD) were calculated. Results: Ten studies (six patellofemoral pain, two knee osteoarthritis, two post-surgery knee pain) were included. The meta-analysis found moderate effect sizes of dry needling for reducing pain (SMD −0.53, 95% CI −0.87 to −0.19) and improving related disability (SMD −0.58, 95% CI −1.08 to −0.09) as compared to a comparison group at short-term. The main effect was observed for patellofemoral pain (SMD −0.64, 95% CI −1.17 to −0.11). No significant effects were observed at mid- or long-term follow-ups. The risk of bias was generally low, but the heterogenicity and the imprecision of the results downgraded the level of evidence. Conclusion: Low to moderate evidence suggests a positive effect of trigger point dry needling on pain and related disability in patellofemoral pain, but not knee osteoarthritis or post-surgery knee pain, at short-term. More high-quality trials investigating long-term effects are clearly needed.

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