Dry Needling Versus Conventional Physical Therapy in Patients With Plantar Fasciitis

Patients with plantar fasciitis will be randomly assigned to receive 1-2 treatments per week for 4 weeks of either: (1) Dry Needling and conventional physical therapy, or the (2) Conventional physical therapy (stretching, strengthening, ultrasound, manual therapy, and cryotherapy)

Inclusion criteria

• Report of at least 3 months of heel pain
• Patient has not had physical therapy, massage therapy, chiropractic treatment, or injections for plantar heel pain in the least 4 weeks.
• Diagnosis of plantar heel pain with ALL of the following positive clinical signs:

• "First---step" pain upon weight bearing in the morning OR after sitting for a period of time
• Pain localized over the medial calcaneal tubercle
• Increased pain with extended walking OR standing >15 minutes
• Plantar heel pain greater than or equal to 2/10 (NPRS 0-10 Scale)

Exclusion criteria

• Report of red flags to manual physical therapy to include: hypertension, infection, diabetes, peripheral neuropathy, heart disease, stroke, chronic ischemia, edema, severe varicosities, tumor, metabolic disease, prolonged steroid use, fracture, RA, osteoporosis, severe vascular disease, malignancy, etc.
• History of previous surgery to the tibia, fibula, ankle joint, or foot.
• History of arthrosis or arthritis of the ankle and/or foot.
• History of significant ankle and/or foot instability.
• Two or more positive neurologic signs consistent with nerve root compression, including any two of the following:

• Muscle weakness involving a major lower extremity muscle group
• Diminished lower extremity patella or Achilles tendon reflexes
• Diminished / absent sensation in any lower extremity dermatome
• Involvement in litigation or worker's compensation regarding their foot pain.
• Any condition that might contraindicate the use of electro---needling
• The patient is pregnant