A Comparative Study of Two Dry Needling Interventions for Plantar Heel Pain

Physical therapy approaches continue evolving. During the last years, minimally invasive techniques such as percutaneous needle electrolysis (PNE) was being developed, obtaining promising results for tendon pathology. PNE technique is a minimally invasive treatment that consists of an application of a galvanic electrolytic current that causes a controlled local inflammatory process in the target tissue. This allows for phagocytosis and the subsequent regeneration of the affected tissue. Nowadays, PNE is being used in clinical practice to manage MTrP, but there are no studies supporting that they have an additional beneficial effect over DN.

From a biological point of view, it seems reasonable to ascertain that a patient will obtain benefits thanks to the mechanical effects provided by the needle and that patients may benefit more if the electrolysis effect is added to the mechanical stimuli provided by the needle. Therefore, the aim of this randomized controlled study is to compare the effectiveness of DN versus PNE for the level of pain in patients suffering from PHP.

Inclusion criteria

• Clinical diagnosis of PHP in accordance with the Clinical Guidelines linked to the International Classification of Function, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association
• Age greater than 21 years according to the Kuwaiti law.
• History of plantar heel pain for greater than one month.
• Walking 50 meters without any support
• Having MTPs on initial physical examination on plantar and calf muscles
• Accepting to be treated by a male physiotherapist.
• Capacity to understand the study and the informed consent, as well as having signed the document.

Exclusion criteria

• - Needle phobia
• Allergy from needles or hypersensitivity to metals
• Presence of coagulopathy or use of anticoagulants
• Presence of peripheral arterial vascular disease
• Pregnancy
• Dermatological disease with the dry needling area
• The presence of a chronic medical condition that might preclude participation in the study such as malignancy, systemic inflammatory disorders (e.g. psoriatic arthritis, ankylosing spondylitis, septic arthritis), neurological diseases, polyneuropathy, mononeuropathy.
• Treatment of plantar heel pain with needling or acupuncture during last 4 weeks.
• A history of injection therapy in the heel in the previous three months.
• Previous history of foot surgery or fracture.