Additive Effect of Therapeutic Ultrasound in the Treatment of Plantar Fasciitis: A Randomized Controlled Trial.

Abstract

Plantar fasciitis is the chief cause of pain in the plantar surface of the heel. Therapeutic ultrasound is one of the most common conservative treatment modalities used by physical therapists worldwide, despite scarce evidence of its efficacy in treating plantar fasciitis. To evaluate the additive effect of therapeutic ultrasound in the treatment of plantar fasciitis in terms of pain, function, and quality of life. In this prospective, randomized, double-blind, placebo-controlled clinical trial, 54 patients with plantar fasciitis, aged 24 to 80 years, who met the inclusion criteria were randomized into an active intervention and a control group. Individuals in the active intervention group were treated with self-performed stretching of the plantar fascia and calf muscles and with therapeutic ultrasound. Individuals in the control group were treated with the same stretching exercises and sham ultrasound. Both groups received 8 treatments, twice weekly. Outcome measures included a numeric pain-rating scale, the computerized adaptive test for the foot and ankle, and an algometric test. Both groups showed statistically significant improvement in all outcome measures (P<.001, both groups). At the completion of the study, no statistically significant differences were found between the groups in any of the outcomes. The addition of therapeutic ultrasound did not improve the efficacy of conservative treatment for plantar fasciitis. Therefore, the authors recommend excluding therapeutic ultrasound from the treatment of plantar fasciitis and agree with results of previous studies that stretching may be an effective treatment for healing plantar fasciitis. Therapy, level 1b. J Orthop Sports Phys Ther 2018;48(11):847-855. Epub 11 Jul 2018. doi:10.2519/jospt.2018.8110.