Recently, one of our clients asked, “Which is better for treating plantar fasciitis shockwave or dry needling?” This week, I wanted to share a little bit about how each works, what they do, and why we utilize both in the treatment of plantar fasciitis.
Shockwave for treating plantar fasciitis
Shockwave Therapy utilizes high-energy sound waves to stimulate the body’s natural healing processes. It’s non-invasive and has no lingering effects after treatment. It’s best suited for treating more chronic versions of plantar fasciitis (lasting more than 2 months) that haven’t responded to rest, orthotics, or physical therapy.
It works by stimulating neovascularization, breaking up calcifications and tissue densifications, promoting collagen remodeling, and desensitizing pain nerves.
The science behind it has strong support from both meta-analyses and Randomized Controlled Trials. For example, a 2018 systematic review by Chung et al. concluded that shockwave therapy significantly improves pain and function at 3 and 6 months post-treatment when compared to sham versions, medicine, exercises, and dry Needling alone.
Dry Needling for treating plantar fasciitis
Dry Needling is most effective for plantar fasciitis cases associated with calf trigger points, excessive myofascial tightness, or referred heel pain.
It works by reducing muscle hypertonicity (tightness), normalizing tissue input/output in the central nervous system (CNS), and increasing local blood flow.
The evidence for dry needling for treating plantar fasciitis suggests that it can improve pain, particularly in the short term, when used as part of a multimodal approach. A large meta-analysis by Tough et al. in 2020 found that dry needling is most beneficial for plantar fasciitis when combined with stretching or manual therapy, which, of course, we always do at ASR.
So… Which One Should You Use?
This is AND not an OR situation — especially if your plantar fasciitis is tied to both soft tissue dysfunction (which needling targets) and chronic degeneration (which shockwave targets). As all the professional sports teams do, ASR uses both modalities sequentially in plantar fasciitis protocols. Someday, we will even combine these two great modalities with biomolecular therapies, such as peptides, to shorten the healing timeline even further so we can keep y’all running, jumping, lifting, golfing, sparring, etc.
