Effectiveness of Trigger Point Dry Needling for Plantar Heel Pain: A Randomized Controlled Trial.

Phys Ther. 2014 Apr 3;

Authors: Cotchett MP, Munteanu SE, Landorf KB

Abstract
BackgroundPlantar heel pain can be managed with dry needling of myofascial trigger points, however there is only poor quality evidence supporting its use.ObjectiveTo evaluate the effectiveness of dry needling for plantar heel pain.DesignParallel group, participant blinded, randomized controlled trial.SettingA university health sciences clinic.PatientsStudy participants were 84 patients with plantar heel pain of at least one month’s duration.InterventionParticipants were randomised to real or sham trigger point dry needling. The intervention consisted of one treatment per week for six weeks. Participants were followed for 12 weeks.MeasurementsPrimary 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.ResultsAt 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 frequency 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%]).LimitationsIt was not possible to blind the therapist.ConclusionDry needling provided statistically significant improvements in plantar heel pain, but the magnitude of this effect should considered against the frequency of minor transitory adverse events.

PMID: 24700136 [PubMed – as supplied by publisher]