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Efficacy of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis: a systematic review and meta-analysis
  1. Bianca Martins Lourenço,
  2. Mariana Gabrich Moraes Campos,
  3. Laísa Maia,
  4. Brenda Castro,
  5. Renato Guilherme Trede,
  6. Vinícius Cunha Oliveira
  1. Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
  1. Correspondence to Dr Vinícius Cunha Oliveira, Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, 39100-000, Brazil; vcunhaoliveira{at}gmail.com

Abstract

Objective To investigate the effects of pharmacological and non-pharmacological therapies on pain intensity and disability for plantar fasciitis.

Design Systematic review of randomised controlled trials (RCTs).

Data sources AMED, MEDLINE, PEDro, Cochrane, SPORTDiscus, CINAHL, EMBASE and PsycINFO without language or date restrictions up to 3 February 2023.

Eligibility criteria RCTs that evaluated the efficacy of any pharmacological and non-pharmacological therapies compared with control (placebo, sham, waiting list or no intervention) on pain intensity and disability in people with plantar fasciitis. Two reviewers independently screened eligible trials, extracted data, assessed the methodological quality of included trials and assessed the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations framework. Mean differences (MDs) with 95% CIs were reported.

Results Seventeen different therapies investigated in 28 trials were included in the quantitative analysis. For non-pharmacological therapies, moderate certainty evidence showed short-term effects of customised orthoses on pain intensity when compared with control (MD of −12.0 points (95% CI −17.1 to −7.0) on a 0–100 scale). Low certainty evidence showed short-term effects of taping on pain intensity (−21.3 (95% CI −38.6 to −4.0)). Long-term effects and effects on disability are still uncertain. For pharmacological therapies, low to very low quality evidence from few trials with small samples was inconclusive and supports that high-quality trials are needed.

Conclusions Moderate-quality and low-quality evidence demonstrates customised orthoses and taping, respectively, reduce pain intensity in the short term in patients with plantar fasciitis.

PROSPERO registration number CRD42021224416.

  • Randomized Controlled Trial
  • Review
  • Foot injuries

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information.

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Footnotes

  • Twitter @oliveira_vc1

  • Contributors BML, MGMC, LM, BC, RGT and VCO contributed to planning, conduct and reporting of the work described in this article. BML is the author responsible for the overall content as the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.