Laser Therapy for Plantar Fasciitis and Heel Pain
Plantar Fasciitis (PF) can be quite a debilitating disorder. It is commonly described as having pain under the heel of the foot or along the arch of the foot. It is a progressive disorder, where the first few steps in the morning are painful, along with barefoot walking, or pain wearing flat shoes. Prolonged standing, walking or running can aggravated the pain. Many different treatment options have been proven to be effective in treating PF, such as deep tissue work, stretching and manual therapy. But, are there any additional therapies that are effective at treating PF, for example, if the hands-on approach is not yielding results to your liking?
At the Lawlor Clinic, we utilise Class 4 Laser Therapy for a variety of conditions, including PF. But, is it any good? Are there positive results with this approach? Or is it all a load of nonsense? Let’s see what the evidence says.
- Class 4 Laser Therapy
With laser therapy, a light beam is placed on the injured area in an effort to affect cellular metabolism, protein synthesis, wound healing and immune response. The idea is that this will fight the inflammation in the fascia, reduce heel pain, and increase recovery time. 2 papers have evaluated the effectiveness of Class 4 Laser Therapy on chronic PF, and have a strong quality of evidence as they appear on the Cochrane Database of Research.
|Macias, 2015||Kiritisi, 2010|
|Laser Treatment||X2/week for 3 weeks||X1/week for 6 weeks|
|Follow Ups||Before, 1week, 2weeks, 3weeks, 6weeks, 8weeks||Before and at 6weeks|
|Results – Plantar thickness||DNA||A difference in plantar thickness, but not statistically significant (not meaningful)|
|Results – Pain||Statistically significant improvement (p<0.001)||Statistically significant improvement (p=0.001)|
These two studies demonstrate that after 6 sessions of Laser Therapy, the PF pain had significantly reduced when compared to placebos. This shows that laser is effective in treating PF, but it is important to explain to patients that research suggest that the most effective treatment approach is 6 treatments either x2/week for 3weeks or x1/week for 6weeks and then the patient can make up their mind which they would rather.
- Comparing Laser to Extracorporal Shock Wave Therapy (ESWT)
The idea behind ESWT is similar to LLLT. In ESWT, a probe is placed on injured area and shockwaves are pulsed in through the skin to stimulate angiogenesis (new blood vessels) and neurogenesis (new nerve cells). In theory, these aspects stimulate wound healing mechanisms. Again, 2 high quality papers compared the use of LLLT vs ESWT:
|Cinar, 2013||Suleymanoglu, 2014|
|Treatment||X3/week for 3weeks of either ESWT / Laser||X3/week for 3weeks (ESWT)
X3/week for 4weeks (Laser)
Both given stretches for 3 months
|Follow Up||Before and at 3 weeks||Before, after 1st session, after 3 months|
|Results – Plantar Thickness||DNA||Reduction in plantar thickness, more significant reduction in ESWT|
|Results – Pain||Statistically significant reduction in pain with Laser, not in ESWT||Statistically significant reduction in pain with ESWT, not in Laser|
The data above suggests there is no difference between using Laser or ESWT for treating PF. This is because of the conflicting evidence above.
In summary, the evidence demonstrates that Laser (once completed for 6 sessions between 3-6weeks) is very effective in reducing pain levels in those with chronic PF. If you are suffering with PF, or any foot pain, please do not hesitate to contact us today
Yours in Health,
The Lawlor Clinic, Portlaoise
Chiropractic | Golf & Sports Injuries | Active Release Techniques (ART®)