Eficacia de la acupuntura para la fascitis plantar crónica recalcitrante: un ensayo aleatorizado

Plantar fasciitis (PF) is a leading cause of heel pain, yet effective treatments for chronic, recalcitrant cases are scarce. The aim of this randomized, no-treatment-controlled trial was to assess whether acupuncture (a combination of high- and low-intensity acupuncture) would reduce pain in patients with chronic recalcitrant PF compared to a waitlist control. Participants were randomly assigned (2:1:1) to high-intensity acupuncture (n=60), low-intensity acupuncture (n=30), or waitlist control (n=30). The primary outcome was the proportion of responders (≥50% reduction in worst pain intensity) at week 4 for the combined acupuncture groups versus the waitlist control group. Key secondary outcomes included responder rates for high- and low-intensity acupuncture versus waitlist control at weeks 4, 8, and 16. Of 120 randomized participants, 109 (90.8%) completed the trial. At week 4, the proportion of responders was significantly higher in the combined groups than in the waitlist control group (56.7% [95%CI, 46.4%-66.9%] vs 33.3% [95%CI, 16.5%-50.2%]; difference: 23.3% [95%CI, 3.6%-43.1%]; P=0.02), with a similar trend observed through week 16. A graded response to acupuncture intensity was evident: at week 16, the responder rate in the high-intensity acupuncture group was 76.7%, compared to 36.7% in the waitlist control group (difference: 40.0% [95% CI, 19.7%-60.3%]; P<0.001), while the low-intensity acupuncture group had a nonsignificant 20.0% difference (95% CI, -4.7% to 44.7%; P=0.11). Among patients with chronic recalcitrant PF, acupuncture, particularly high-intensity acupuncture, notably reduced pain compared with waitlist control, with lasting effects up to week 16. Keywords.