JMIR Publications

ABSTRACT

Background:

Plantar fasciitis is one of the most common causes of heel pain, often leading to significant functional limitations and decreased quality of life. While conventional treatments such as stretching exercises are widely used, the addition of high-intensity laser therap has shown promising potential in enhancing therapeutic outcomes, though robust clinical evidence remains limited.

Objective:

To evaluate the efficacy of high-intensity laser therapy combined with plantar fascia stretching exercises compared to a sham control in the treatment of plantar fasciitis.

Methods:

This study was designed as a randomized, double-blind, sham-controlled trial conducted at the outpatient clinic of a university hospital. Participants were randomly allocated into two groups: the high-intensity laser therapy group and the sham treatment group. Both groups received a total of nine treatment sessions over a three-week period. The high-intensity laser therapy group received active laser therapy, while the sham group received identical treatment without laser emission. In addition to the assigned interventions, all participants performed a standardized self-stretching exercise program targeting the plantar fascia and Achilles tendon throughout the study period.

Results:

Thirty-four patients diagnosed with unilateral plantar fasciitis were enrolled. Primary outcome: pain measured using a visual analogue scale. Secondary outcomes: ultrasonographic measurement of plantar fascia thickness, and the subjective form of the Foot and Ankle Ability Measure were recorded before and immediately after the intervention. No significant differences were found between the two groups across all outcomes. Pain reduction, measured by the visual analogue scale, was 35.3 millimeters (95% confidence interval: 25.0–45.5) in the high-intensity laser therapy group and 30.4 millimeters (95% confidence interval: 14.4–46.3) in the sham group (P=.59). Similarly, reductions in plantar fascia thickness and improvements in Foot and Ankle Ability Measure scores showed no significant differences between groups (P=.90 and P=.40, respectively). However, both groups demonstrated statistically significant improvements in all outcomes compared to baseline.

Conclusions:

There is no additional clinical effectiveness of high-intensity laser therapy on pain reduction, decreasing plantar fascia thickness, or increasing the Foot and Ankle Ability Measure score in patients with plantar fasciitis compared to sham laser with the standard treatment of stretching exercises for plantar fasciitis and Achilles tendon. Clinical Trial: Thai Clinical Trials Registry registration number: TCTR20200724001; https://www.thaiclinicaltrials.org/show/TCTR2020072400;