What’s the Best Treatment for Plantar Fasciitis?

A recent study from McGill University in Canada looked at treatments for plantar fasciitis.  The authors compared three groups of patients with pain from plantar fasciitis; each group had a different treatment.   

The Makeup of the Study

  • One group underwent extracorporeal shock wave therapy (ECST) with orthotics and a home exercise program 
  • One group had a low-level laser (LLLT) with orthotics and a home exercise program 
  • The last group received only orthotics and a home exercise program 

Treatment Plans

  • The ECST group had to undergo shockwave treatment weekly for three weeks  
  • The LLLT group had to have treatment three times a week for ten sessions 
  • The last group did not have to go to a clinic for treatment 

The Results

The insoles that each group wore were non-custom and shock-absorbing. The exercises were heel cord (calf) stretching and plantar fascia stretching.

The participants were monitored in the three months following their treatments.

All three groups had a reduction in pain.

However, the LLLT group did the best in this study. LLLT and ECST have been recommended to increase cell activation and to stimulate healing. In this particular study, there was no additive effect of going to the clinic for ECST as opposed to simply wearing the orthotics and doing the exercises. However, the LLLT group did have an additive effect. That is, the LLLT therapy group had the most reduction in pain in this study.

The issues with both ECST and LLLT are that neither are covered by insurance and require multiple visits. Also, shock wave therapy is known to be painful. It is up to you to decide if such treatments are worth it for a modest improvement in pain control over conventional therapy, exercise, and insoles.

Cinar EE, Saxena S, Uygur F. Combination therapy versus exercise and orthotic support in the management of pain in plantar fasciitis: A randomized controlled trial. FAI. 2018; 39(4): 406-414

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