Isolated stretching demonstrated superior efficacy in pain reduction compared to the addition of ultrasound or phonophoresis in the treatment of chronic plantar fasciitis.
All three treatment groups showed statistically significant reductions in pain after 15 sessions.
The isolated stretching group (G3) achieved the greatest mean VAS reduction and the lowest final pain score.
Intergroup comparison showed a statistically significant difference favoring isolated stretching over both combined therapy groups.
Adding phonophoresis or therapeutic ultrasound to stretching did not enhance pain reduction compared to stretching alone.
This research suggests that for people with chronic plantar fasciitis (long-lasting heel pain), doing stretching exercises alone may work better than combining stretching with common physical therapy technologies like ultrasound or phonophoresis (a technique that uses ultrasound to deliver medication through the skin). In this study, 60 patients were divided into three groups and received 15 treatment sessions each. All groups experienced meaningful reductions in pain, but the group doing only stretching had the largest pain reduction — about 6.7 points on a 10-point pain scale — compared to roughly 4.9 and 4.3 points for the groups that added phonophoresis or ultrasound, respectively. The stretching-only group also ended up with the lowest final pain score (0.9 out of 10). This research suggests that adding technological interventions like ultrasound or phonophoresis to a stretching program may not provide additional benefit — and in this study, their addition was actually associated with less pain improvement than stretching alone. This finding challenges the assumption that more complex or technology-assisted treatments are necessarily better. The results support stretching as an effective, simple, and likely more cost-efficient approach for managing chronic plantar fasciitis pain. It is worth noting that this was a relatively small study (20 patients per group) conducted at a single rehabilitation unit, and longer follow-up data were not reported. Future research with larger samples and longer observation periods would help confirm these findings. Nonetheless, this study adds to growing evidence that structured stretching programs are a cornerstone of plantar fasciitis management.
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Upload Your LabsOtero-Varela A, Rojano-Mejía D, Luja-Ramírez L, Salcedo-Vargas M, Vega-García A, García-Pérez A. (2026). [Chronic plantar fasciitis: Effectiveness of stretching, ultrasound, and phonophoresis. A randomized clinical trial].. Revista medica del Instituto Mexicano del Seguro Social. https://doi.org/10.5281/zenodo.21462666