Dry Needling and Fascial Manipulation Techniques in Plantar Fasciitis.
Comparative Effects of Fascial Manipulation and Dry Needling Technique in Management of Chronic Plantar Fasciitis
Riphah International University
36 participants
Oct 1, 2025
INTERVENTIONAL
Conditions
Summary
The goal of this randomized controlled clinical trial is to evaluate whether Fascial Manipulation (FM) or Dry Needling (DN) can effectively reduce pain, improve functional mobility, and enhance range of motion (ROM) in individuals with chronic Plantar Fasciitis (PF) aged 25-45 years The main questions it aims to answer are: * Does Fascial Manipulation significantly reduce pain intensity in patients with chronic Plantar Fasciitis? * Does Dry Needling provide comparable or superior improvements in functional mobility and ankle-foot ROM compared to Fascial Manipulation? Researchers will compare the Fascial Manipulation group to the Dry Needling group to determine which intervention is more effective in improving pain and functional outcomes in chronic PF. Participants will: Receive either Fascial Manipulation or Dry Needling interventions according to their assigned group. Attend treatment sessions twice a week for six weeks. Undergo baseline, mid, and post-intervention assessments of pain (VAS-100scale), functional mobility (FFI), diagnostic (PFPS, Windlass, and ankle-foot range of motion (goniometric measurements).
Eligibility
Inclusion Criteria6
- Participants falling in this category would be recruited into the study.
- Females aged 25-45 years with chronic heel pain with symptoms persisting for more than one month.
- Having a heel pain on the first step during the last week with the rate of at least 40 mm on visual analogue scale.
- Presence of morning heel pain, tenderness at the medial calcaneal tubercle, and heel spur, or pain exacerbated by prolonged standing, walking, or dorsiflexion
- Patients accepting to discontinue analgesics, non-steroidal anti-inflammatory medications and oral/topical paracetamol during the study period.
- Patients diagnosed with plantar fasciitis using Plantar fasciitis questionnaire.
Exclusion Criteria13
- Participants fall in this category would be excluded of the study.
- History of foot or ankle fractures, surgeries, or inflammatory conditions like RA.
- Presence of any neurological disorders affecting gait.
- Participants with diagnosed tendinopathies, including Achilles tendinopathy, posterior tibial tendinopathy, etc. will be excluded from the study to ensure the specificity of plantar fasciitis.
- Participants with metabolic disorders (e.g., osteomalacia, osteoporosis, rheumatoid arthritis, diabetes) affecting bone and soft tissue integrity will be excluded to prevent confounding effects on pain, healing, and treatment outcomes
- Active infections, open wounds, or skin conditions at the treatment site.
- Diabetic neuropathy or vascular insufficiencies that may affect healing and sensations.
- Patients with bleeding disorders like hemophilia and those on anti-coagulant therapy.
- Patients with hypersensitivity reactions to needles or specific metals used in needles.
- Patients with needle phobia.
- Patients with history of epilepsy or seizures.
- Use of corticosteroid injections, shockwave therapy, or other invasive treatments for PF in the last 3 months.
- Participation in another clinical trial or conflicting therapy during the study period
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Interventions
Fascial Manipulation (FM) targets myofascial dysfunction by applying deep manual pressure to densified fascial layers involved in chronic pain and mobility restrictions. The following techniques will be used: * Fascial Release Techniques: This technique will target Plantar fascia, gastrocnemius, soleus, Achilles tendon, and intrinsic foot muscles * Myofascial Stretching: Passive ankle dorsiflexion with toe extension to stretch the plantar fascia and posterior chain Conventional Exercises: Hot pack before fascial manipulation for 10 mins, stretching Exercises (Plantar Fascia Stretch, gastrocnemius stretch, soleus Stretch, towel stretch) and strengthening Exercises (Toe curls, resisted ankle dorsiflexion with resistance band, heel raises). Total duration is 2 sessions per week for 6 consecutive weeks
Dry Needling: Dry needling (DN) is an effective technique for releasing myofascial trigger points, reducing pain and improving muscle function. The following protocol will be used: The targeted areas are: (plantar fascia, gastrocnemius (medial \& lateral heads), soleus, tibialis posterior) Sterile monofilament needles (0.30 mm x 30 mm) will be used. The needle will be inserted perpendicularly into trigger points by Piston (rapid in and out technique). Duration will be done twice a week for 6 weeks. Conventional Exercises: Ice therapy after dry needling to overcome soreness, stretching Exercises (Plantar Fascia Stretch, gastrocnemius stretch, soleus Stretch, towel stretch) and strengthening Exercises (Toe curls, resisted ankle dorsiflexion with resistance band, heel raises). Total duration is 2 sessions per week for 6 consecutive weeks.
Locations(1)
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NCT07426783