Dry needling for plantar heel pain

Introduction: Plantar heel pain is a common cause of foot disability, and dry needling is increasingly used when first-line conservative care is insufficient. The comparative effectiveness of dry needling against sham needling or other conservative treatments remains unclear. Methods: This systematic review followed PRISMA 2020. Results: Of 242 records identified and 127 screened, 12 randomized trials with 680 participants were included. Dry needling added to conventional care produced greater reductions in pain and greater functional gains than conventional care alone in most trials, and dry needling reached outcomes comparable to those of corticosteroid injection, extracorporeal shock wave therapy and percutaneous needle electrolysis. Risk of bias was high in eight trials and of some concern in four. Conclusions: Dry needling reduces pain and improves foot function in plantar heel pain, principally as an adjunct to conventional treatment, but the certainty of the evidence is low and the clinical advantage over other active comparators is small and inconsistent.