Table 1.

Randomized controlled trials of chiropractic and physical therapy modalities for plantar fasciitis

Authors and Year	Intervention	Comparison intervention	Outcome Measures	Results	Comments
Dimou, et al. 2004	Chiropractic adjustments of foot and ankle, twice weekly for four weeks, and at one month follow-up. Achilles tendon stretching (knee straight and bent) for 20 seconds, ten times each, three times per day for eight weeks.	Custom functional shock-absorbing orthotics from subtalar and midtarsal and neutral casts. Manufactured by a podiatrist, worn for eight weeks.	Numeric Pain Rating Scale 101, first step pain scale, effect of heel pain on leisure, work, and exercise. Algometry pressure pain threshold on maximal area of tenderness. Baseline measurements were taken, as were measurements at 15 days, 29 days, and one month follow-up (eight weeks after baseline).	No adverse events reported in either group. Both groups saw significant improvements in pain rating, first step pain, heel pain during leisure, and algometer measurements. There was not a significant difference between the interventions, except for pain ratings on day 15 which favored chiropractic adjustments with stretching over orthotics.	Due to a very small sample size (n=10 per group) it is difficult to draw any meaningful conclusions. A longer treatment period, more treatments, and longer follow-up are also advised. No drop-outs from this study protocol.
Basford et al. 1998	30mW continuous-wave 0.83 micrometer GaAlAs IR diode laser, the probe was held for 33 seconds over plantar fascia insertion on the calcaneus, and for two 33 second sweeps over the medial plantar fascia. Three times per week for four weeks (12 sessions total).	Same protocol, except a placebo laser treatment using a non-energized probe was employed. Three times per week for four weeks	Physical exam results (heel walking, windlass testing, pain on palpation). Subjective pain rating compared to baseline, reports of pain on first step in morning, duration of pain, effect of pain on activities, medication use, activity level, side effects, and use of orthotics. Measures taken at first, sixth, and twelfth session, and one month follow-up. Follow-up also asked for assessment of treatment effectiveness and group assignment.	No significant differences were observed between groups during treatment or at follow-up. No significant adverse events were reported.	28 subjects completed the trial and follow-up, a small sample size. Authors concluded that laser therapy is ineffective in treating plantar fasciitis. 12.5% drop-out rate when considering treatment and follow-up, 3.1% drop out rate for treatment phase only.
Crawford and Snaith 1996	Therapeutic ultrasound at an intensity of 0.5w/cm2, 3MHz, pulsed 1:4 for eight minutes along with coupling gel. Two times weekly for four weeks.	Sham ultrasound with coupling gel for eight minutes. Two times weekly for four weeks.	Visual analogue scale at first and last (eighth) visit.	Both groups showed a decrease in pain, the treatment group averaged 30% improvement, while the placebo group averaged 25% improvement. There was not a statistically significant difference in outcome between the treatment and placebo groups. None of the subjects experienced a complete resolution of pain. No adverse effects reported although two patients in each group reported worse pain at the end of the trial, one patient in each group neither improved nor worsened.	19 patients with 26 painful heels entered the trial, a small sample size. No drop-outs from this study protocol. No long term follow-up. The authors recommend additional studies using different ultrasound parameters.