2023 Medical Acupuncture

Acupuncture combined with a home-exercise program significantly reduces pain in patients suffering from plantar fasciopathy more than just a home exercise program.

A randomized controlled trial was set up at two U.S. Air Force military treatment facilities using subjects over 18 years old suffering from plantar fasciopathy. In total, 94 subjects were divided into two groups; those who only did home exercises and those who did home exercises and received acupuncture. The intervention group got acupuncture every other week, four times in total. There was no blinding and after an initial 12-week study, patients in the control group were given an option to cross over to acupuncture. The main focus of the trial outcomes was on reduction of pain and improved functioning, with scores taken at baseline, every visit, and six weeks after treatment.

The outcome revealed that the control group had a notable reduction in pain at the end of the study, the intervention group had over a 50% reduction in pain immediately after every acupuncture session and a sustained reduction in pain at the termination of the study. In addition, subjects who crossed over to acupuncture from the control group observed a considerable drop in their pain scores instantly as well as at the 12 weeks post-acupuncture point. However, while function scores did enhance, there was no significant statistical difference.

Acupuncture for Plantar Fasciopathy: A Randomized Controlled Trial Cagle SD, Covey C, Farrell J, Sharon DJ, Crawford P

2021 Medical Acupuncture

Acupuncture displays potential as a safe and effective treatment for foot and ankle pain, providing pain relief and functional improvement.

The researchers gathered Randomized Controlled Trials (RCTs) from 6 major English databases, and relevant systematic reviews manually via Google Scholar. The selected RCTs studied the comparison of acupuncture with various types of sham acupuncture and nonactive or waitlist controls in terms of pain intensity, functional status, and general quality of life. All procedures including study screening, data extraction, risk of bias assessment, and quality assessment were conducted independently. Instead of performing a quantitative synthesis, the team opted for a narrative synthesis as quantitative pooling wasn't fit for the collected data.

Four RCTs involving a total of 211 participants were included. Due to distinct clinical heterogeneity involving all the outcomes, the team did not conduct a quantitative analysis. Using a quality grading system, all outcomes were rated as supported by low or very low-quality evidence. Despite this, the study still showed acupuncture is potentially effective for treating participants with plantar fasciitis or Achilles tendinopathy, in terms of pain relief and functional status improvement, over short- and intermediate-term follow-ups. Notably, no adverse events linked to acupuncture use were reported.

The Efficacy of Acupuncture on Foot and Ankle for Pain Intensity, Functional Status, and General Quality of Life in Adults: A Systematic Review Trinh K, Belski N, Zhou F, Kuhad A, Luk D, Youn E

2021 Medical Acupuncture

Acupuncture displays potential as a safe and effective treatment for foot and ankle pain, providing pain relief and functional improvement.

The researchers gathered Randomized Controlled Trials (RCTs) from 6 major English databases, and relevant systematic reviews manually via Google Scholar. The selected RCTs studied the comparison of acupuncture with various types of sham acupuncture and nonactive or waitlist controls in terms of pain intensity, functional status, and general quality of life. All procedures including study screening, data extraction, risk of bias assessment, and quality assessment were conducted independently. Instead of performing a quantitative synthesis, the team opted for a narrative synthesis as quantitative pooling wasn't fit for the collected data.

Four RCTs involving a total of 211 participants were included. Due to distinct clinical heterogeneity involving all the outcomes, the team did not conduct a quantitative analysis. Using a quality grading system, all outcomes were rated as supported by low or very low-quality evidence. Despite this, the study still showed acupuncture is potentially effective for treating participants with plantar fasciitis or Achilles tendinopathy, in terms of pain relief and functional status improvement, over short- and intermediate-term follow-ups. Notably, no adverse events linked to acupuncture use were reported.

The Efficacy of Acupuncture on Foot and Ankle for Pain Intensity, Functional Status, and General Quality of Life in Adults: A Systematic Review Trinh K, Belski N, Zhou F, Kuhad A, Luk D, Youn E

2020 Acupuncture in Medicine

Electroacupuncture and manual acupuncture show similar effectiveness in relieving plantar heel pain syndrome with no significant difference between the two modalities.

In this research, participants were randomly divided into two groups to receive either electroacupuncture (EA) or manual acupuncture (MA) treatments. They underwent a course of 12 treatment sessions over a span of 4 weeks, followed by 24 weeks of follow-up. The study prioritized the assessment of treatment responders, who were identified as patients showcasing at least a 50% reduction from their initial worst pain intensity experienced during the initial steps in the morning after 4 weeks of treatment.

The study encompassed 92 patients diagnosed with PHPS, enlisted between July 2018 and June 2019. A total of 78 patients (85% of the original group) successfully completed both the treatment and follow-up. The results highlight that after the 4-week treatment period, both the EA and MA groups experienced a decrease in heel pain and showed improved plantar function with no serious treatment-related adverse events. Interestingly, no significant differences were observed between the two groups in terms of pain intensity relief or in any secondary outcomes after 4 weeks of treatment and at follow-up points at 16 and 28 weeks.

Comparison of electroacupuncture and manual acupuncture for patients with plantar heel pain syndrome: a randomized controlled trial Wang W, Liu Y, Jiao R, Liu S, Zhao J, Liu Z

2020 Acupuncture in Medicine

Electroacupuncture and manual acupuncture show similar effectiveness in relieving plantar heel pain syndrome with no significant difference between the two modalities.

In this research, participants were randomly divided into two groups to receive either electroacupuncture (EA) or manual acupuncture (MA) treatments. They underwent a course of 12 treatment sessions over a span of 4 weeks, followed by 24 weeks of follow-up. The study prioritized the assessment of treatment responders, who were identified as patients showcasing at least a 50% reduction from their initial worst pain intensity experienced during the initial steps in the morning after 4 weeks of treatment.

The study encompassed 92 patients diagnosed with PHPS, enlisted between July 2018 and June 2019. A total of 78 patients (85% of the original group) successfully completed both the treatment and follow-up. The results highlight that after the 4-week treatment period, both the EA and MA groups experienced a decrease in heel pain and showed improved plantar function with no serious treatment-related adverse events. Interestingly, no significant differences were observed between the two groups in terms of pain intensity relief or in any secondary outcomes after 4 weeks of treatment and at follow-up points at 16 and 28 weeks.

Comparison of electroacupuncture and manual acupuncture for patients with plantar heel pain syndrome: a randomized controlled trial Wang W, Liu Y, Jiao R, Liu S, Zhao J, Liu Z

2016 Journal of Orthopaedic & Sports Physical Therapy

Acupuncture, specifically needle-based and electroacupuncture, can potentially provide therapeutic benefits for carpal tunnel syndrome, Achilles tendinopathy, and shoulder injuries.

Methodology: The researchers executed a systematic review on multiple databases such as MEDLINE, Embase, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials covering a period from 1990 to 2015. Their search was focused on identifying responsive randomized controlled trials, cohort studies, and case-control studies which focused on the effectiveness and safety of acupuncture therapies for musculoskeletal disorders. The Scottish Intercollegiate Guidelines Network criteria was used to evaluate the eligible studies. Furthermore, best-evidence synthesis was performed to sum up results from studies with low bias risk. A sensitivity analysis was also performed to comprehend the potential impact of excluding studies with high bias risk.

Results: The comprehensive review identified 5180 articles, from which 15 were selected for final analysis (10 had a low risk of bias and 5 with a high risk of bias). Among other findings, the results showed that traditional needle acupuncture may outperform oral steroids and vitamin B1/B6 supplements for carpal tunnel syndrome and exercises for Achilles tendinopathy. Moreover, electroacupuncture might be superior than placebo for shoulder injuries. The extent of benefits offered by dry needling for plantar fasciitis remained equivocal. Traditional needle acupuncture didn't show significant advantage over placebo for upper extremity pain, or no intervention for patellofemoral pain, and findings for shoulder pain were inconclusive.

Effectiveness of Acupuncture Therapies to Manage Musculoskeletal Disorders of the Extremities: A Systematic Review Cox, J., Varatharajan, S., Côté, P., & Optima Collaboration

2013 BMC Complementary Medicine and Therapies

Acupuncture has shown potential in alleviating symptoms and improving overall quality of life for patients suffering from ankle sprains.

To evaluate the effectiveness of acupuncture in treating ankle sprains, the researchers performed a systematic review, sourcing data from 15 databases and two trial registries up until February 2012. Only randomized controlled trials of acupuncture that involved patients with ankle sprains and reported improvements of symptoms, particularly pain, were included. Different aspects such as the type of acupuncture, the grade of sprain, and the type of control were considered. The risk of bias and sample size were assessed using a Cochrane risk of bias tool, and sensitivity analyses were performed regarding these factors and reported outcomes.

In relation to the results, they incorporated 17 trials with a total of 1820 participants. It was found that overall quality of the trials was lacking, with only three properly describing their randomization methods, and just one detailing a method for obscuring allocation. More participants who received acupuncture reported a global improvement of symptoms compared to those who did not undergo acupuncture. Additionally, acupuncture as an auxiliary treatment also enhanced global symptoms compared to other treatments alone, without significant changes in results. The advantages of acupuncture remained notable even after limiting the analysis to the two trials with the lowest risk of bias. Acupuncture proved to be more efficient than other control methods in reducing pain, enabling return to normal activities, and enhancing quality of life. However, these analyses relied on a small range of studies. Acupuncture did not seem to be connected with any detrimental events.

Acupuncture for ankle sprain: systematic review and meta-analysis Park J, Hahn S, Park JY, Park HJ, Lee H

2012 Acupuncture in Medicine

There is evidence supporting the effectiveness of acupuncture for plantar heel pain comparable to that available for conventionally used interventions, such as stretching, night splints or dexamethasone.

Five randomised controlled trials and three non-randomised comparative studies were included. High quality studies report significant benefits. In one, acupuncture was associated with significant improvement in pain and function when combined with standard treatment (including non-steroidal anti-inflammatory drugs). In another, acupuncture point PC7 improved pain and pressure pain threshold significantly more than LI4. Other papers were of lower quality but suggest benefits from other acupuncture approaches.

The Effectiveness of Acupuncture for Plantar Heel Pain: A Systematic Review Clark RJ, Tighe M

2011 Evidence-Based Complementary and Alternative Medicine

Acupuncture can provide pain relief to patients with plantar fasciitis.

This study demonstrates that acupoint PC7 has a specific effect for treatment of plantar fasciitis, and that the method of acupuncture treatment is both simple and safe. Further studies comparing acupuncture treatment with an inert placebo and conventional treatment as parallel arms are recommended to further elucidate the efficacy of acupuncture treatment for heel pain.

Acupuncture treatment for plantar fasciitis: a randomized controlled trial with six months follow-up Shi Ping Zhang , Tsui-Pik Yip, Qiu-Shi Li