Britny Blevins, Clinical Support Specialists
Plantar Fasciitis is one of the most common causes of heal pain, affecting about 2 million people in the United States (Schwartz & Su, 2014) and accounts for approximately 15% of foot symptoms requiring medical care in adults (Geldwert & Minara). The plantar fascia is a thick fibrous ligament that runs on the bottom of the foot from the calcaneus (heel bone) to the toes and helps support the arch of the foot. Plantar Fasciitis is due to inflammation of this ligament, is typically a strain injury, causing micro tears in the ligament. Symptoms of this common condition include throbbing, burning, and/or piercing type of heel pain especially with the first few steps in the morning. Pain can persist anywhere from hours with an acute flair up to years if it’s a chronic condition.
Typical treatments for plantar fasciitis include anti-inflammatory drugs, orthotic insoles, limiting physical activities, and stretching. These treatments can extend to physical therapy, steroid injections, extracorporeal shock wave therapy (ESTW), ultrasound therapy, and night splints. In advanced cases, surgery is also a treatment option.
Therapies for plantar fasciitis evolve further as technology in the medical field is researched and developed. One such technology is Low Level Laser Therapy (LLLT). This therapy modality uses lasers that safely penetrate the skin to accelerate wound healing, decrease pain, and decrease inflammation (Kimlickova, Efremova, Blaskova, Navratil, & Navratil).
One such mechanism of action on the body is promoting tissue regeneration. Ulusoy, Cerrahoglu, and Orguc (2017) conducted a randomized controlled trial to determine and compare the clinical effects of LLLT, ESTW, and Ultra Sound therapy for patients with plantar fasciitis. The team objectively analyzed patients via MRI to measure fascia thickness as well as VAS for heel pain, foot functionality test, and heel tenderness index. 60 patients were enrolled in the study and were placed into one of three groups: LLLT, UltraSound, or ESWT treatment. It was found that LLLT and ESWT were more effective than Ultra Sound therapy for all 4 measurements (p<.001).
Multiwave Locked System (MLS) Laser Therapy is an advanced type of LLLT that was developed by rigorously testing and pairing several different wavelengths of low level lasers. MLS uses 905nm and 808nm wavelengths that are locked together in a patent delivery system thus enabling the wavelengths to synergistically reciprocate each other. When compared to traditional LLLT, MLS was found to be more effective, achieved much faster results, and needed much fewer applications (Kimlickova, Efremova, Blaskova, Navratil, & Navratil).
When treating plantar fasciitis patients with MLS, treatment times are short (approximately 7 minutes each) and there is no invasive procedure. New York City Podiatrist Dr. Josef Geldwert and his study team conducted a randomized study to determine the effects of MLS Laser Therapy on 20 patients with plantar fasciitis for 6 MLS laser therapy sessions. Results were obtained via pain VAS and ultrasound measurements of the fascia were taken. The study found VAS decreased (average pre treatment VAS of 6.2 and decreased to an average of 2.6), and average sonographic measurement of the plantar fascia was 0.48cm before treatment to 0.43cm after treatments. Overall, 80% of subjects reported a decrease in symptoms after being treated with MLS Laser Therapy.
LLLT, in particular MLS Laser Therapy, has been proven to help patients who suffer from plantar fasciitis.
Geldwert, J., & Minara, R. (n.d.). The Effect of a Class IV Multiwave Locked System Laser on Plantar Fasciitis.
Kimlickova, M., Efremova, Y., Blaskova, E., Navratil, V., & Navratil, L. (n.d.). A comparison of effects of therapy with the NIR laser diode and MLS laser system. Energy for Health.
Schwartz, E., & Su, J. (2014). Plantar Fasciitis: A Concise Review. The Permanente Journal, 105-107.
Ulusoy, A., Cerrahoglu, L., & Orguc, S. (2017). Magnetic Resonance Imaging and Clinical Outcomes of Laser Therapy, Ultrasound Therapy, and Extracorporeal Shock Wave Therapy for Treatment of Plantar Fasciitis: A Randomized Controlled Trial. The Journal of Foot and Ankle Surgery, 762-767.