Electroacupuncture for Plantar Fasciopathy: A Multisite Randomized Clinical Trial

Objective: Determine if adding an acupuncture protocol with electrostimulation to a standard exercise program improves pain and function in adult patients with plantar fasciopathy more than a standard exercise program alone. Intervention: In this randomized, multisite controlled study, patients were randomized to either receive a local electroacupuncture protocol plus home exercise program or a home exercise program alone. Acupuncture treatments were performed every 2 weeks for 6 weeks with a 6-week follow-up for a total study period of 12 weeks. The home exercise program included stretching and strengthening exercises over a 5-week period. Main Outcome and Measure: The primary outcome was change in the patients’ reported Defense and Veterans Pain Rating Scale (DVPRS) scores. The secondary outcome was change in the Revised Foot Function Index-Revised (FFI-R) Short Form questionnaire. Results: Seventy-two subjects were enrolled, with 37 randomized into the acupuncture plus exercise group (58 feet) and 35 randomized into the exercise group alone (59 feet). Demographics were similar between the two groups. Significantly stronger declines over time were observed in the intervention group for both DVPRS pain scores (12 week decline of 2.17 compared with 1.62 in the comparison group, interaction coefficient of −0.07, 95% confidence interval [CI]: −0.13, −0.01) and FFI-R scores (12 week decline of 19.5 compared with 12.9 in the comparison group, interaction coefficient of −0.65, 95% CI: −1.20, −0.10). Overall, 23 out of 25 subjects in the acupuncture plus exercise group reported that they were satisfied with their acupuncture treatment. Conclusions and Relevance: Acupuncture with electrostimulation plus prescribed exercise decreases pain and improves function in both the short and long term in adult patients with plantar fasciopathy, more than exercise alone. These findings add to evidence that acupuncture is an important adjunctive treatment option in the management of common outpatient clinic problems. Trial Registration: NCT04243343.