File
Z. Alboloushi1,2, D. Herrero3, M. Arian4, P. Bellosta3
1Ministry of Health Kuwait/ University Zaragoza, Physical Therapy, Kuwait, Kuwait, 2University Zaragoza, Physical Therapy, Zaragoza, Spain, 3San Jorge University, Physical Therapy, Zaragoza, Spain, 4Ministry of Health Kuwait, Physical Therapy, Kuwait, Kuwait
Background: Plantar heel pain (PHP) is a common problem affecting the foot, causing soreness or tenderness in the sole of the foot, and under the heel, sometimes extending into the medial arch.1The frequency and incidence of PHP is uncertain, however it is estimated that over the course of a lifetime 10% of the population may suffer from this condition. Several pathologies may cause PHP, such as myofascial pain syndrome, plantar fasciitis or heel spur, amongst others.4The clinical diagnosis is usually established based on the patient’s history and physical examination, including pain during the first steps in the morning or after prolonged rest, as well as pain during prolonged standing or walking.235The identification of the main cause of pain can be challenging as this is often multifactorial, 6and despite its prevalence, the etiology of PHP is not well understood.23The presence of myofascial trigger points (MTrPs) within the muscles of the foot and lower leg may play an important role in people in PHP, 7an implicit assumption underlying many recent studies.8-11In addition, there is a lack of consensus regarding the ideal management approach for PHP.
Clinical practice guidelines support the use of conservative treatment, such as joint and soft tissue mobilization or self-stretching home programs.
In particular, self-stretching home programs have shown to be effective for addressing PHP.
Clinical practice guidelines support the use of conservative treatment, such as joint and soft tissue mobilization or self-stretching home programs.
In particular, self-stretching home programs have shown to be effective for addressing PHP.
Purpose: Objectives: To compare the effectiveness of dry needling versus percutaneous needle electrolysis for improving the level of pain, function and quality of life of patients suffering from plantar heel pain provoked by myofascial trigger points.
Methods: A prospective, parallel-group, randomized controlled trial with blinded outcome assessment.
Results: Foot Pain domain improved at all time points for dry needling group(P<0.001;29.7 [17.8 to 41.5]) and percutaneous needling electrolysis group (P<0.001;32.7 [18.3 to 47.0]), without significant differences between groups. Pain VAS scores decreased at all time points for both dry needling (P<0.001; -2.6[-4.0 to -1.2]) and percutaneous needling electrolysis group (P<0.001;-3.0 [-4.5to -1.6]). Quality of Life improved at 4 weeks for both dry needling (P<0.01; 0.15[0.5 to 0.25]) and percutaneous needling electrolysis group (P<0.01; 0.09 [0.01to 0.17]and at 8 and 52 weeks for the percutaneous needle electrolysis group (P<0.01; 0.10 [0.02to 0.18), with significant differences between groups for the quality of life at 52 weeks (P<0.05; 0.10 [0.01 to 0.18]). There were two small hematomas in the percutaneous needle electrolysisgroup and one in the dry needling group. No serious adverse events were reported.
Conclusion(s): Bothpercutaneous needle electrolysisand dry needling were effective for plantar heel pain management, reducing mean and maximum pain since the first treatment session, with long lasting effects (52 weeks) and significant differences between groups in the case of Quality of Life at 52 weeks in favor of the percutaneous needle electrolysisgroup.
Implications: This is the first RCT conducted in Kuwait and gcc as far as we know in dry needling. One of the strengths is that this is the first RCT to analyze the effectiveness of percutaneous needle electrolysis and to compare it with dry needling for PHP caused by MTrPs, with a large sample size and a long follow-up.
Funding, acknowledgements: This research received funding from Ministry of Health Kuwait as part of PhD studies of Zaid Al-Boloushi.
Keywords: Plantar heel pain, Dry Needling, Percutaneous Needle Electrolysis
Topic: Pain & pain management
Did this work require ethics approval? Yes
Institution: Ministry of Health Kuwait
Committee: Medical Ethics Committee
Ethics number: (642/2017).
All authors, affiliations and abstracts have been published as submitted.
