In 2020, Gupta, et. al., conducted study about the realm of plantar fasciitis treatment, various modalities such as rest, stretching, orthotics, and anti-inflammatory agents have been recommended. However, a noticeable gap exists in the literature—there is a lack of studies comparing the individual effectiveness of these treatments without their concurrent use. Addressing this void, our study aims to rigorously examine and compare different treatment modalities for plantar fasciitis.

To conduct an in-depth investigation, we initiated a double-blind, randomized controlled trial involving 140 patients diagnosed with plantar fasciitis. The participants were systematically divided into four groups, each comprising 35 individuals. The treatment regimens for these groups included analgesics, hot water fomentation, and silicon heel pads; plantar fascia stretching exercises; and calf stretching exercises. Heel pain and disability assessments were carried out using the Foot Function Index (FFI) and the Foot and Ankle Disability Index (FADI), respectively. Clinical evaluations were conducted weekly over a span of 4 months, with subsequent assessments at 6, 8, 10, and 12 months.

The average age of the patients was 43.4 years, with symptoms persisting for an average duration of 27.26 weeks (range 4-200 weeks). Notably, both FFI and FADI scores exhibited statistically significant improvements across all four groups at the 12-month mark (p value < 0.0001 for all groups). However, Groups 2, 3, and 4 demonstrated superior results in terms of reducing heel pain (FFI) compared to Group 1 (ANOVA, p value < 0.0001 for Group 1 vs. 2, Group 1 vs. 3, and Group 1 vs. 4). Regarding disability (FADI), Group 3 emerged with the most favorable outcomes.

Our findings shed light on the efficacy of distinct treatments for plantar fasciitis. Plantar fascia stretching exercises proved to yield the most significant improvements in both FFI and FADI scores, followed closely by the combination of heat and silicone heel pads, and calf stretching exercises. This study contributes valuable insights to the optimization of plantar fasciitis management strategies, emphasizing the importance of tailored therapeutic approaches.

Reference: Gupta, R., Malhotra, A., Masih, G. D., Khanna, T., Kaur, H., Gupta, P., & Kashyap, S. (2020). Comparing the role of different treatment modalities for plantar fasciitis: a double blind randomized controlled trial. Indian journal of Orthopaedics, 54, 31-37.