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In a recent systematic review and meta-analysis of research on plantar fasciitis, the authors reviewed electronic databases through September 2022, calculating mean differences (MDs) and 95% confidence intervals (CIs) to determine efficacy of different treatment strategies for this common painful condition.


Overall certainty evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation.


Of the 236 studies that met the required criteria, the total number of patients amounted to 15,401.


Treatments reviewed included:


* Extracorporeal shock wave therapy (MD -0.97, CI: -1.13, -0.81: MD -2.49 CI: -3.17, -1.82);


* Botulinum toxin (results: MD -2.14, CI: -4.15, -0.14);


* Micronized dehydrated human amnion/chorion membrane injection (MD -3.31, CI: -5.54, -1.08);


* Dry needling (MD -2.34, CI: -4.64, -0.04);


* Low-dye taping (MD -3.60, CI: -4.16, -3.03);


* Low-level laser therapy (MD -2.09, CI: -2.28, -1.90);


* Myofascial releases (MD -1.79, CI: -2.63, -0.94);


* Platelet-rich plasma (MD -2.40, CI: -4.16, -0.63);


* Radiofrequency (MD -2.47, CI: -4.65, -0.29); and


* Stretching (MD -1.14, CI: -2.02, -0.26).



In the short term, all of these therapies resulted in effective pain treatment when compared to control. However, only extracorporeal shock wave therapy was effective for improving pain over medium and long term when compared to the control (see first bullet, above).


The study concluded that, when evaluating available studies, systematic review and meta-analysis showed that different therapeutic interventions are useful strategies for improving pain initially in patients with plantar fasciitis. In the medium and long term, only extracorporeal shock wave therapy is effective. (See: Guimaraes JS, Arcanjo FL, Leporace G, et al. Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis. Clin Rehabil. 2022 Dec 26:2692155221143865. doi: 10.1177/02692155221143865.)