Every year, more than two million people are treated for plantar fasciitis in this country. Plantar fasciitis affects the band of tissue that supports the arch of the foot: the plantar fascia. If you’ve ever had a bout of plantar fasciitis, you can attest to just how painful this condition is—especially first thing in the morning. Fortunately, effective, nonsurgical treatments are available to relieve plantar fasciitis symptoms. In this article, we’ll discuss the benefits of dry needling for plantar fasciitis to treat the intense, stabbing pain many people experience due to this injury.
The plantar fascia is a long, thin ligament located just beneath the skin. It runs along the bottom of the foot and connects the front of the foot to the heel. The plantar fascia also supports the arch of the foot and absorbs the stress placed on the foot during exercise, sports, and everyday activities like walking and climbing.
Excess strain on the plantar fascia, can trigger an inflammatory response. Over time, the fascia can thicken and exhibit signs of degeneration due to overloading the body’s capacity to heal itself. Often, tight muscles in the calf and muscle imbalances throughout the leg are to blame to this strain. The result is intense heel pain and stiffness.
Plantar fasciitis is described as a “stabbing” sensation that is most intense after waking up, after extended periods of rest, and after intense activity. It is a leading cause of foot pain and mobility problems. Plantar fasciitis pain can interfere with exercise, work, and all the other tasks and activities that fill our day. The good news is this can be treated.
There are some common risk factors for plantar fasciitis. People who participate in prolonged or repetitive high-impact sports and activities are at risk of developing the condition, as are those who spend long periods of time on hard flat surfaces, like teachers and healthcare providers, for example.
The anatomy of the foot also plays a part in heel function and mobility. Individuals with high arches and/or flat feet are more prone to plantar fascia inflammation and pain. The condition is also more common among people ages 40-60 and those who carry excess weight.
Dry needling is a therapeutic technique used to relieve muscular pain and increase range of motion in the surrounding joints. Also referred to as myofascial dry needling, or trigger point therapy, dry needling involves the insertion of fine, sterile nickel plated needles directly into the skin and the muscle in areas where knots of taut muscle have formed. These knots are called trigger points.
Trigger points form in areas of the body that experience acute or repetitive trauma due to everything from physical injuries to emotional stress and poor posture. Areas that hold tension like the neck, shoulders, back, and hips commonly develop trigger points. Trigger point pain can be local or referred, as with someone with plantar fasciitis caused by tight muscles on the inner part of the calf who experiences pain in their heel.
No. Although dry needling and acupuncture both involve the use of thin, sterile needles inserted into specific areas of the body, the two techniques are actually quite different. Physical therapists who treat pain with dry needling have different training and licensure guidelines than acupuncturists, and the theory behind both modalities differs as well.
Acupuncture is a form of Chinese medicine dating back thousands of years. Needles are inserted at key points along energy channels called meridians located throughout the body. The primary philosophy is to heal the body when energy flow is released to improve the body’s well-being and can be used to reduce pain.
The goal of dry needling is to stimulate the nervous system which causes a neurochemical change and releases endorphins to relieve the tension, pain, and improve range of motion of the affected tissue for symptom relief. Dry needling is used to treat a wide variety of conditions including a multitude of physical conditions, headaches, and muscle aches.
As the needle penetrates the skin and reaches the muscle beneath, it releases tension to inactivate trigger points, ease pain, and improve movement. Dry needling is also shown to interrupt pain messages to the brain, another way this procedure contributes to pain relief for patients with plantar fasciitis and other musculoskeletal conditions.
Dry needling is a quick and effective treatment for plantar fasciitis that for many, provides discernable changes after just one session. To begin treatment, you will sit or lay on the mat table in a comfortable position that allows your physical therapist to access the bottom of your foot. They will physically examine your foot to locate the trigger points and other areas of muscle stiffness causing pain and soreness.
Once the treatment area has been cleaned, your therapist holds your foot or lower leg securely and inserts a short, sterile, needle into the skin and into the involved muscles. Insertion points to release trigger points and relieve pain in the plantar fascia are typically located in the calf, but may also be done at the base of the heel, in the mid-arch, at the ball of the foot, and on the side of the foot in line with the arch.
Needles are inserted directly into the trigger point, or in the surrounding muscle. If you tolerate the procedure well, your therapist may turn the inserted needles or raise them up and down slightly to further stimulate blood flow and the relaxation response for greater symptom relief.
Typically, needles are left in the treated area for anywhere from a few seconds up to 15 minutes or more. When they are removed, you may have a drop or two of blood, as if you had pricked your finger. Mild soreness in the bottom of the foot is also possible.
Patients may experience relief from plantar fasciitis anywhere from a few days to several weeks after starting treatment. As plantar fasciitis most often has other contributing factors such as tightness in the calf muscle or muscle imbalances in the leg and hip, dry needling is typically recommended in conjunction with exercise and other physical therapy techniques for long-lasting pain relief for patients with plantar fasciitis.
You may feel something akin to a tiny pin prick, pressure, or an ache as the needles penetrate the skin. Because the needles are so fine, some patients do not even feel them being inserted.
You might have sensitivity or experience involuntary muscle twitching as they reach the trigger points. There can be discomfort when the needles are placed within the trigger points or during manual maneuvers of the needles, however this is followed by relief of symptoms. Let your physical therapist know if you experience any discomfort during treatment.
Licensed physical therapists have a deep understanding of the body’s anatomy and injuries and conditions affecting the musculoskeletal system. Physical therapists skilled in dry needling have undergone additional, specialized post-graduate training and education in this particular modality.
Do you want to learn more about dry needling? Find a physical therapy clinic near you to schedule a screening for your foot pain.