Ice Packs Versus Cold Baths Combined With Standard Exercise Therapy for Plantar Fasciitis

Plantar fasciitis is one of the most common causes of plantar heel pain and is associated with functional limitations, reduced mobility, and impaired quality of life. Conservative management is considered the first-line treatment and typically includes therapeutic exercises, stretching, strengthening, patient education, and cryotherapy. Although cryotherapy is widely used to relieve pain and reduce tissue inflammation, there is limited evidence comparing the effectiveness of different cryotherapy modalities in patients with plantar fasciitis.

This study is a prospective, parallel-group, randomized controlled trial designed to compare the clinical effectiveness of ice pack application and cold bath immersion when both are combined with a standardized exercise therapy program.

Eligible adults diagnosed with plantar fasciitis will be randomly allocated into one of two intervention groups:

Group A: Ice pack therapy combined with standard exercise therapy. Group B: Cold bath immersion combined with standard exercise therapy.

Both groups will receive identical exercise therapy consisting of plantar fascia stretching, calf muscle stretching, eccentric heel raises, and balance training. Cryotherapy will be administered for 10 minutes per session, five sessions per week, for two weeks.

The primary outcome will be pain intensity measured using the Visual Analogue Scale (VAS). The secondary outcome will be functional disability measured using the Foot Function Index (FFI). Outcome assessments will be performed at baseline and immediately after completion of the two-week intervention period.

The study hypothesizes that one cryotherapy modality may provide superior pain relief and functional improvement when combined with standard exercise therapy. The results are expected to provide evidence for selecting the most effective, low-cost, and easily applicable cryotherapy intervention for conservative management of plantar fasciitis and may contribute to evidence-based physiotherapy practice.

Inclusion criteria

• Adults aged 18 to 65 years.
• Clinical diagnosis of unilateral or bilateral Plantar Fasciitis.
• Heel pain localized to the medial calcaneal tubercle.
• Positive Windlass test.
• Pain intensity of ≥4 on the Visual Analogue Scale (VAS) at baseline.
• Willing and able to provide written informed consent.
• Willing to comply with the study protocol and attend all treatment and assessment sessions.

Exclusion criteria

• History of foot or ankle surgery within the previous 6 months.
• Corticosteroid injection for plantar fasciitis within the previous month.
• Neurological disorders affecting the lower limb.
• Peripheral vascular disease or other vascular disorders affecting the lower limb.
• Open wounds, skin infections, or contraindications to cryotherapy.
• Pregnancy.
• Participation in another interventional clinical trial during the study period.
• Inability to follow the study protocol or complete outcome assessments.