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Laser Therapy for Plantar Fasciitis and Heel Pain

28 September 2016
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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.

 

  1. 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
Participants 69 25
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.

 

  1. 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
Participants 55 81
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®)



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