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The effectiveness of acupuncture for plantar heel pain: a systematic review
  1. Richard James Clark1,
  2. Maria Tighe2
  1. 1Peninsula College of Medicine and Dentistry, Plymouth University, Plymouth, UK
  2. 2Faculty of Health, Education and Society, School of Nursing and Midwifery, Plymouth University, Plymouth, UK
  1. Correspondence to Dr Richard J Clark, Peninsula College of Medicine and Dentistry, C206 Portland Square, Drake Circus, Plymouth PL4 8AA, UK; Richard{at}IntegrativeHealthcare.co.uk

Abstract

Introduction Plantar heel pain (PHP) is a common complaint, yet there are no definitive guidelines for its treatment. Acupuncture is increasingly used by podiatrists, and there is a need for evidence to validate this practice. It is acknowledged that PHP and acupuncture are both complex phenomena.

Method A systematic review (PROSPERO no. CRD42012001881) of the effectiveness of acupuncture for PHP is presented. Quality of the studies was assessed by independent assessors with reference to Quality Index (QI), ‘STandards for Reporting Interventions in Controlled Trials of Acupuncture’ (STRICTA) and ‘CONsolidated Standards Of Reporting Trials’ (CONSORT) criteria. Pooling of data, or even close comparison of studies, was not performed.

Results 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.

Conclusions There is evidence supporting the effectiveness of acupuncture for PHP. This is comparable to the evidence available for conventionally used interventions, such as stretching, night splints or dexamethasone. Therefore acupuncture should be considered in recommendations for the management of patients with PHP. Future research should recognise the complexity of PHP, of acupuncture and of the relationship between them, to explore the optimum use and integration of this approach. There is a need for more uniformity in carrying out and reporting such work and the use of STRICTA is recommended.

  • Acupuncture
  • Sports Medicine
  • Pain Management
  • Orthopaedic & Trauma

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