Objectives To compare the effectiveness of dry needling (DN) versus percutaneous needle electrolysis (PNE) for improving the level of pain, function and quality of life (QoL) of patients suffering from plantar heel pain (PHP) provoked by myofascial trigger points.
Design A prospective, parallel-group, randomised controlled trial with blinded outcome assessment.
Setting A single treatment facility in the State of Kuwait.
Participants 118 participants were screened for eligibility. Of these, 102 participants were enrolled (30 men (49.5±8.9 years) and 72 women (48.1±8.8 years)) and 68 of them completed the trial.
Interventions Two parallel groups, one study arm received DN and a stretching protocol whereas the other arm received percutaneous needling electrolysis with a stretching protocol.
Primary and secondary outcome measures The primary outcome measure was the Foot Pain domain of the Foot Health Status Questionnaire, with 13 questions related to foot health-related domains. Secondary outcome measures included the 0–10 numerical rating scale pain visual analogue scale (VAS) scores, performed before and after each treatment session. In addition, QoL was measured using the EuroQoL-5 dimensions. All measurements were taken at baseline, at 4, 8, 12, 26 and 52 weeks.
Results Foot Pain domain improved at all time points for DN group (p<0.001; 29.7 (17.8 to 41.5)) and percutaneous needling electrolysis group (p<0.001; 32.7 (18.3 to 47.0)), without significant differences between groups. Pain VAS scores decreased at all time points for both DN (p<0.001; −2.6 (−4.0 to −1.2)) and percutaneous needling electrolysis group (p<0.001; −3.0 (−4.5 to −1.6)). QoL improved at 4 weeks for both DN (p<0.01; 0.15 (0.5 to 0.25)) and percutaneous needling electrolysis group (p<0.01; 0.09 (0.01 to 0.17)) and at 8 and 52 weeks for the PNE group (p<0.01; 0.10 (0.02 to 0.18)), with significant differences between groups for the QoL at 52 weeks (p<0.05; 0.10 (0.01 to 0.18)). There were two small haematomas in the PNE group and one in the DN group. No serious adverse events were reported.
Conclusions Both PNE and DN were effective for PHP management, reducing mean and maximum pain since the first treatment session, with long lasting effects (52 weeks) and significant differences between groups in the case of QoL at 52 weeks in favour of the PNE group.
Trial registration number NCT03236779.
- pain management
- rehabilitation medicine
- sports medicine
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Contributors ZA-B, EMG-T, PB-L and PH conceived of the idea and developed the design of the trial. ZA-B and MA developed the intervention and collected data. ZA-B, EMG-T, PB-L, DF and PH were involved in development of the statistical analysis of the trial. All authors contributed to writing the article and have read and approved the final manuscript.
Funding This research received funding from Ministry of Health Kuwait as part of PhD studies of Zaid Al-Boloushi.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Ethics approval The study was conducted in compliance with the Declaration of Helsinki of Human Rights and ethical approval was obtained by the Medical Ethics Committee of the State of Kuwait Ministry of Health, with reference number 642/2017.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All the anonymised data related to the different clinical outcomes may be obtained from the corresponding author on reasonable request in an excel/SPSS format for secondary analysis (ie, meta-analysis). Study protocol is publicly available at: 10.1186/s13018-019-1066-4.
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