Effect of Local Laser Therapy on Plantar Fasciitis: A Meta-Analysis

Background/Objectives: Plantar fasciitis (PF) is a leading cause of heel pain and functional impairment in adults. Laser therapy, in its low-intensity laser therapy (LLLT), high-intensity laser therapy (HILT), and photobiomodulation (PBMT) modalities, has been proposed as a non-invasive alternative, although its clinical effectiveness remains a subject of debate. The aim of this systematic review and meta-analysis was to evaluate the efficacy of laser therapy in reducing pain, improving function, and modifying fascial thickness in patients with PF. Methods: A comprehensive search was conducted in PubMed, Embase, and PEDro (last search: August 2025). Randomized controlled trials comparing laser therapies versus placebo or alternative physical interventions were included. Two reviewers performed study selection, data extraction, and risk of bias assessment using the PEDro scale. Random-effects meta-analyses were performed for pain (VAS), heel tenderness (HTI), function (FFI, AOFAS, ASQoL, SF-36), and fascial thickness, expressing effects as standardized mean differences (SMDs) or mean differences (MDs). Results: Thirteen trials with 784 participants were included. Laser therapy showed a significant improvement in heel tenderness (SMD = -0.40; 95% CI -0.71 to -0.09; I² = 0%). No significant differences were observed in overall pain (SMD = -0.18), function (SMD = 0.20), or fascial thickness (MD = -0.18 mm). Pain and function analyses showed high heterogeneity. Conclusions: Laser therapy may reduce heel tenderness in plantar fasciitis, but it does not consistently improve overall pain, function, or fascial thickness. Its use should be considered as a therapeutic adjunct and not as a primary intervention. Larger trials with standardized protocols are needed.