Early studies show 95% success rate for plantar fasciitis that has not responded to standard treatments

For stubborn plantar fasciitis that does not respond to standard therapy there is a promising, fast, minimally invasive and inexpensive new treatment available to you in our Seattle clinic. Called Percutaneous Ultrasound Guided Approach to Plantar Fasciitis” or “dry needling”, it was developed by researchers at the Department of Experimental Medicine at the University of Genoa, Italy. In a preliminary study that included 44 patients, researchers achieved a 95 percent success rate in completely resolving plantar fasciitis symptoms, relief that has so far lasted for more than ten months since the procedure.

The Procedure

The procedure has a terrible name – “dry needling” – but we make sure that it is painless for you. Here is how it works:

  1. We numb your foot with a local anesthetic. The procedure is not started until you are completely numb. We don’t want you to experience any pain at all.
  2. Using ultrasound imaging, we use an empty hypodermic needle to repeatedly puncture the plantar fascia. The ultrasound images allow us to precisely place the needle. Then, once again using the ultrasound imaging to ensure precise placement, we place a steroid at the site where you have been having pain.

How Does it Work to Treat Plantar Fasciitis?

The dry needling induces minor bleeding in the tissues. In addition, some researchers feel that it helps to break up scar tissue at the heel. The minor bleeding recruits blood cells to heal this tissue – which normally has rather poor circulation. Injecting the steroid, especially with the precise placement available with the use of ultrasound guidance, reduces inflammation and helps eliminate the risk of fascia rupture.

How Long Does the Procedure Take?

The entire procedure lasts about 15 minutes.

What Happens After the Procedure?

You might experience some tenderness in the foot. This is usually controlled with Tylenol or Advil. Following the procedure, we ask that you wear a removable walking cast-boot for 5 – 7 days. This simply gives the foot a chance to rest and start the healing process. After you finish with the cast, you should wear stable shoes with orthotics or arch supports for the next two weeks.

What are the Benefits of the Procedure?

  • Early studies show 95% success with lasting relief for most patients.
  • Current studies show relief lasting at 10 months
  • Relief within 2 – 3 weeks according to studies
  • One-time treatment
  • Performed in our office – no need for hospital
  • Much less risk than surgery
  • Much less expensive than shockwave therapy or surgery

What are the Risks of the Procedure?

  • Some patients have pain for several days following procedure
  • Still a relatively new procedure, so long-term results past 12 months unknown
  • Could lead to weakening of the plantar fascia and possible rupture.
  • However, long term inflammation from plantar fasciitis can cause the same problem.
  • Small risk of post-injection infection
  • Allergic reaction from the anesthesia

Don’t live with heel pain or arch pain. Call today to make an appointment in our convenient Seattle office.

We recently received some questions about this procedure from  a patient who was considering dry needling for her plantar fasciitis. Her questions and our answers are below.

We had a potential patient ask us some very good questions regarding the dry needling procedure that we use for chonic heel pain at the Seattle Heel Pain Center. He would be driving up from Portland to have the procedure done and wanted to see if he was a good candidate before making the trip.  Here are his questions and our answers:

Q:  I know the original study/experiment in Italy had success in 42 of 44 patients treated, what is the success rate that you have noted for your patients?

A:  I haven’t kept stats, but so far I’ve been very happy with the outcomes.   I don’t think I’ve had a patient who wasn’t happy they had it done, although not everyone has had 100% success.   Let’s say about 80 – 90% success.

Q: I have read that one of the benefits to this treatment is that a return to normal activities is fairly quick.  How long is the recovery period?

A:  Keep in mind the that purpose of dry needling is to take a chronic problem and put it into an acute healing period.  I put patients in a walking boot for 2 weeks after we do the procedure and then back into normal shoes.  You can exercise, but I recommend against running for 3 months and jumping sports such as basketball for 6 months.

Q: I know everything is contingent on a physical examination, but would dry-needling an acceptable option for me despite not having a “super severe” case of PF even though it has been with me over one year in duration?

A:  Whether you are a good candidate depends primarily on how thick your plantar fascia is.  We will measure it using ultrasound.  If it is not excessively thick, then you would not be a good candidate.

Q: What is the cost of the procedure?

A: We bill only for an exam, ultrasound guided injection and steroid injection.  I can look tomorrow for exact cost, but I think it comes out to around $400.

Q: In some cases I have heard of doctors injecting plasma/platelets, ala PRP injections instead of a steroid.  Would there be any difference or benefit to either one?

A:  We have looked at PRP but have seen no studies that make us think it is an effective treatment.

If you have heel pain, contact us today for an appointment at the Seattle Heel Pain Center.