This randomized controlled trial evaluated the efficacy of manual physiotherapy in improving clinical outcomes and sonographic features in patients with plantar fasciitis (PFS). A total of 122 participants were divided into three groups: group A (40 patients with PFS) received manual physiotherapy, group B (42 patients with PFS) received no intervention, and group C (40 healthy subjects) served as controls. The primary outcomes included the morphology of the plantar fascia (PF), thicknesses of the calcaneal fat pad (CFP) and Kager’s fat pad (KFP), pain intensity, and foot functional limitation. These were assessed at baseline and one month after treatment.
Results showed that PF thickness was significantly increased in both group A and B compared to group C (P < 0.001). Group A, however, showed more significant improvements in PF echogenicity and reduction in CFP thickness (P < 0.001). Specifically, group A patients experienced notable improvements in PF thickness (P < 0.001), PF echogenicity (P < 0.001), and CFP thickness (P = 0.002) following the one-month treatment. Furthermore, pain intensity and foot functional limitation significantly improved in group A, particularly in patients in the acute phase of PFS.
In conclusion, manual physiotherapy was found to be effective in treating PF thickening, hypoechogenicity, pain, and functional limitations in patients with plantar fasciitis, especially for those in the acute phase. These findings suggest that manual physiotherapy should be considered as an effective treatment option for managing plantar fasciitis, with ultrasound imaging serving as an important tool for monitoring treatment efficacy.
