Effectiveness of Trigger Point Dry Needling for Plantar Heel Pain

It is possible to manage plantar heel pain with dry needling of myofascial trigger points, however there is only poor quality evidence supporting its use. The objective of this study was to evaluate the effectiveness of dry needling for plantar heel pain.DesignParallel group, participant blinded, randomized controlled trial. Study participants were 84 patients with plantar heel pain having persisted for at least one month. Participants were seperated at random into real or sham trigger point dry needling. The intervention consisted of one treatment per week for six weeks. Participants were followed for 12 weeks. Primary outcome measures included ‘first-step pain’ measured with a Visual Analogue Scale and foot pain measured with the pain subscale of the Foot Health Status Questionnaire. The primary end-point for predicting the effectiveness of dry needling for plantar heel pain was six weeks. At the primary end-point, significant effects favored real dry needling over sham dry needling for pain (adjusted mean difference: VAS first-step pain -14.4 mm, 95% CI -23.5 to – 5.2, p=0.002; FHSQ foot pain 10.0 points, 95% CI 1.0 to 19.1, p=0.029), although the between-group difference was lower than the minimal important difference. The number needed to treat at six weeks was 4 (95% CI 2 to 12). The prevalence of minor transitory adverse events was significantly greater in the real dry needling group (70 real dry needling appointments [32%] compared with only 1 sham dry needling appointment [<1%]). It was not possible to blind the therapist.

The study found that dry needling produced statistically significant improvements in plantar heel pain, but the magnitude of this effect should considered against the frequency of minor transitory adverse events.

Sensorimotor Impairment in Neck Pain

Join Chris Worsfold in this short online course to learn about the evaluation and rehabilitation of sensorimotor impairment in patients with neck pain.