Authors: Yigal Katzap, MPT

Study Design
A prospective, randomized, double-blinded, placebo-controlled clinical trial.

Background
Plantar fasciitis is the main cause of pain in the plantar surface of the heel. One of the most common conservative treatment modalities used by physical therapists worldwide is therapeutic ultrasound, despite the scarce evidence of its efficacy in the treatment of plantar fasciitis.

Objective
To evaluate the additive effect of therapeutic ultrasound in the treatment of plantar fasciitis in terms of pain, function, and quality of life.

Methods
54 patients afflicted with plantar fasciitis, aged 24-80, who met the inclusion criteria, were randomized into an active intervention group and treated by self-performed stretching of the plantar fascia and calf muscles in addition to therapeutic ultrasound. The control group was treated with the same stretching exercises with an addition of sham ultrasound. Both groups received eight treatments, twice weekly. Outcome measures included a Numeric Pain Rate Scale (NPRS), the Foot & Ankle Computerized Adaptive Test (CAT) and an algometric test.

Results
Both groups showed statistically significant improvement in all outcome measures (P<0.001, both groups). At the completion of the study, no statistically significant differences were found between the groups in any of the outcomes.

Conclusions
The addition of therapeutic ultrasound did not improve the efficacy of conservative treatment for plantar fasciitis, therefore, we recommend excluding therapeutic ultrasounds from the treatment of plantar fasciitis. We agree with the results of previous studies that stretching may be an effective treatment for healing plantar fasciitis.

Level of Evidence
Therapy, Level 1b. J Orthop Sports Phys Ther, Epub 11 Jul 2018. doi:10.2519/jospt.2018.8110