A recent randomized controlled trial conducted at two United States Air Force medical treatment facilities has confirmed the efficacy of acupuncture in reducing heel pain associated with plantar fasciitis. The results demonstrate statistically significant improvements in acute and sustained pain reduction among patients receiving acupuncture in addition to home exercise, in contrast to those treated with exercise alone [1].
This trial enrolled 94 Department of Defense beneficiaries aged 18 or older diagnosed with plantar fasciitis (PF), a chronic degenerative condition affecting the plantar fascia of the foot. Participants were randomized into two groups: a control group receiving only a standardized home exercise program, and an intervention group receiving both acupuncture and the same exercise protocol. Each acupuncture participant received four treatments administered biweekly over four weeks [1].
Pain intensity was measured using the Numeric Pain Rating Scale (NPRS) at each treatment session and six weeks post-intervention. Functional improvement was also assessed using the Foot and Ankle Ability Measure (FAAM). These measures were recorded at baseline, each visit, and at follow-up [1].
The acupuncture protocol utilized a set of standardized acupuncture points selected for their therapeutic relevance to foot pain and fascial tension. The following acupoints were used:
- KD3 (Taixi)
- BL60 (Kunlun)
- GB40 (Qiuxu)
- SP6 (Sanyinjiao)
- Ashi points directly at the site of plantar pain
Each treatment used sterile, single-use stainless steel needles measuring 0.25 mm in diameter and 40 mm in length. Needles were inserted perpendicularly to a depth of 15–30 mm, depending on tissue resistance and anatomical site, to elicit the deqi sensation. Manual stimulation was performed until deqi was confirmed, after which needles were retained for 30 minutes. No electrical stimulation was used in the study protocol [1].
The results showed a statistically significant reduction in acute pain after each acupuncture session. The intervention group exhibited an average immediate reduction of over 50% in NPRS scores after each treatment (p < 0.05), and a cumulative 37% reduction in pain at the end of the study (p < 0.01). In comparison, the control group experienced only a 21% reduction in pain at the conclusion of the six-week protocol (p < 0.05) [1].
Though no serum biomarker analysis was conducted in this study, the authors noted that the rapid and reproducible pain reduction observed immediately post-treatment supports a neuromodulatory mechanism of action. Acupuncture likely modulates nociceptive pathways via afferent nerve fiber stimulation at local and distal points, reducing central sensitization often present in chronic plantar fasciitis cases [1].
The researchers emphasized the specificity of acupoint selection in yielding these results. By focusing on points known to influence the kidney, bladder, gallbladder, and spleen channels, as well as local Ashi points, the intervention effectively targeted both systemic and local aspects of foot pain. The inclusion of bilateral needling at the standard acupoints used in the study also suggests a systemic regulatory effect beyond the localized region of pain [1].
The four-session biweekly model demonstrated meaningful clinical improvements. While functional improvements did not differ significantly from exercise alone, the addition of acupuncture offered a marked and immediate reduction in subjective pain levels, enhancing patient comfort and potentially facilitating better adherence to rehabilitative exercise programs [1].
This randomized controlled trial substantiates the analgesic efficacy of acupuncture for patients with plantar fasciitis. The findings support the integration of acupuncture into multidisciplinary treatment protocols for foot pain, especially in populations treatment must be maximally effective and safe [1].
Source
[1] Hannan, R., Hill, J., & Curtis, K. (2022). “Acupuncture Combined with Exercise for the Treatment of Plantar fasciitis: A Randomized Controlled Trial.” Medical Acupuncture, 34(3), 163–171.
