A Comparative Study of Two Dry Needling Interventions for Plantar Heel Pain

University of Zaragoza

Status: Completed

Conditions: Plantar Fascitis; Trigger Point Pain, Myofascial; Myofacial Pain Syndromes

Treatments: Other: dry needling

Study type: Interventional

Funder types: Other

Identifiers

NCT03236779

ALBOLOUSHI

Details and patient eligibility

About

This is a clinical trial that will be done in the state of Kuwait, at the physical rehabilitation medicine hospital. the participants will be recruited from all over Kuwait, there is a clinical registry upon the ethical committee in Kuwait assigned by the ministry of health.

Full description

Physical therapy approaches continue evolving. During the last years, minimally invasive techniques such as percutaneous needle electrolysis (PNE) was being developed, obtaining promising results for tendon pathology. PNE technique is a minimally invasive treatment that consists of an application of a galvanic electrolytic current that causes a controlled local inflammatory process in the target tissue. This allows for phagocytosis and the subsequent regeneration of the affected tissue. Nowadays, PNE is being used in clinical practice to manage MTrP, but there are no studies supporting that they have an additional beneficial effect over DN.

From a biological point of view, it seems reasonable to ascertain that a patient will obtain benefits thanks to the mechanical effects provided by the needle and that patients may benefit more if the electrolysis effect is added to the mechanical stimuli provided by the needle. Therefore, the aim of this randomized controlled study is to compare the effectiveness of DN versus PNE for the level of pain in patients suffering from PHP.

Enrollment: 102 patients

Sex: All

Ages: 21 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Clinical diagnosis of PHP in accordance with the Clinical Guidelines linked to the International Classification of Function, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association
• Age greater than 21 years according to the Kuwaiti law.
• History of plantar heel pain for greater than one month.
• Walking 50 meters without any support
• Having MTPs on initial physical examination on plantar and calf muscles
• Accepting to be treated by a male physiotherapist.
• Capacity to understand the study and the informed consent, as well as having signed the document.

Exclusion criteria

• • Needle phobia
• Allergy from needles or hypersensitivity to metals
• Presence of coagulopathy or use of anticoagulants
• Presence of peripheral arterial vascular disease
• Pregnancy
• Dermatological disease with the dry needling area
• The presence of a chronic medical condition that might preclude participation in the study such as malignancy, systemic inflammatory disorders (e.g. psoriatic arthritis, ankylosing spondylitis, septic arthritis), neurological diseases, polyneuropathy, mononeuropathy.
• Treatment of plantar heel pain with needling or acupuncture during last 4 weeks.
• A history of injection therapy in the heel in the previous three months.
• Previous history of foot surgery or fracture.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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102 participants in 2 patient groups

Dry needling (DN) arm

Experimental group

Description:

Once the clinician locates the MTrP, he will insert the needle over it and he will do a quick entry of the needle. The chosen technique to manipulate the needle will be Hong technique, which consist of quick entry and exit of the needle (fast in/fast out) to get local twitch response (LTR), it will be repeated 5 times with a rhythmic movement of 1Hz/sec. LTRs will be counted and registered.

Treatment:

Other: dry needling

Percutaneous needle electrolysis (PNE) arm

Active Comparator group

Description:

The electrotherapy equipment used (Enraf) produces a continuous galvanic current through the cathode (modified electrosurgical scalpel with the needle) while the patient holds the anode (handheld electrode). Once the needle have reach the relevant treatment area, a continuous current of 3 pulses at an intensity of 3, 1.5 mA for 5 seconds conveyed to the muscle will be applied. It will be done exactly the same way as in the DN group with the only difference that the needle will be transmitting the electrical current.

Treatment:

Other: dry needling