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

Pain Med. 2021 Mar 24:pnab114. doi: 10.1093/pm/pnab114. Online ahead of print.

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.

PMID:33760098 | DOI:10.1093/pm/pnab114

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