The foot condition called plantar fasciitis is a big pain in the…heel. If you have this, you know it with every step you take. That smarting pain happens because the plantar fascia, a thick band of tissue on the sole of the foot that connects the heel to the toes, is burning and sore with inflammation.

Exercise, icing, use of orthotic shoe inserts and, ultimately, corticosteroid injections are the usual treatments to dull the pain and help the plantar fascia calm down, relax and let you walk with ease again. But those treatments don’t always work very well, and the steroids can have some nasty side effects. So here’s good news: A new acupuncture technique under study in China is outpacing steroid injections in its ability to provide safer, more lasting relief of pain and inflammation for people with plantar fasciitis…and to get the body to naturally heal itself.

The treatment involves the insertion of something called a miniscalpel needle (MSN) into the most painful point on the affected heel. Don’t be put off by the term “scalpel”—this procedure isn’t painful! The tool is shaped like an acupuncture needle but has a flat edge on the tip. For this reason, it is sometimes called an “acuneedle.” Its development was inspired both by traditional acupuncture needles and by other Chinese medicine techniques that force the body to heal itself—as we’ll see below!

WAY BETTER THAN STEROIDS

The effectiveness of the MSN technique was recently tested in a study of 54 patients with plantar fasciitis who had gotten no relief from six months of treatments such as anti-inflammatory drugs, physical therapy and use of heel cushions. The next step would normally be corticosteroid injections as needed so, in this study, about half of the patients received a corticosteroid injection and the other half were given an MSN insertion procedure. Before being treated, all the patients rated their pain on a 10-point scale on which 10 meant excruciating pain and 0 meant no pain. The average pain scale rating for patients in both groups before treatment was about 7—enough pain to make getting around on foot miserable.

The MSN technique involved numbing the heel of the affected foot and then inserting the needle in a way similar to that of an acupuncture needle. The needle was moved up and down three to five times to “release” the plantar fasciitis and then taken out. Next, the doctor performing the procedures applied pressure to the spot for two minutes to keep it from bleeding before patching it with a bandage. Patients in both groups were instructed to stay off the affected foot as much as possible for the next two days.

One, six and 12 months after receiving treatment, patients rated their pain again. At one month, patients who had received the MSN treatment reported that their pain had significantly improved—their pain scores dropped way down from an average 7 to 1.6. Meanwhile, the average score of folks who received a corticosteroid injection dropped only three points, from 7 to 4. Patients who had received MSN were still feeling much better at six and 12 months, with pain scores dropping down even further to about 1—meaning that they hardly had any plantar fasciitis pain anymore. Meanwhile, pain scores for the patients who had received the corticosteroid injection instead of the MSN treatment were rapidly rising again to where they had been before treatment.

Side effects among people receiving the MSN technique were minor…a few people had soreness at the needle insertion site and one person had some mild bleeding, but these effects went away within two days of the procedure.

This study was a small but well-done, said orthopedic acupuncturist Don Lee, LAc, president of the American Association of Acupuncture and Oriental Medicine, who was not part of the study but who I reached out to for his take on the study and how the information could be used by my readers here in the US. “The MSN is actually not a needle as we know it,” he said. “The device actually looks like a small screwdriver, and the needle is more than twice as thick as the needles used for traditional acupuncture.” That may sound painful in and of itself, but, remember, the heel is numbed before the MSN is used. Also—and this may really surprise you—the point of the technique is to intentionally cause an injury beneath the skin to rally the body’s healing resources to the whole affected area.

HOW YOU CAN BENEFIT

You may not have ready access (yet) to MSN in the United States, but there are techniques that have similar effects. Lee compared MSN to a traditional technique used in Chinese medicine called gua sha, (pronounced gwah sah), which means “scraping sand.” In this technique, the skin of the affected area is scraped until red rashlike spots called petechiae form. This causes the tissue to release chemicals, such as histamines and heparins, which increase blood flow. Increased blood flow, in turn, increases the flow of oxygen and nutrients to the area, healing it and clearing out waste products.

Gua sha is now commonly being used by acupuncturists and physical therapists to treat conditions such as plantar fasciitis. Plus, a Western technique called instrument-assisted soft tissue mobilization, which is based on gua sha and used by physical therapists, is specifically being used to treat plantar fasciitis, carpal tunnel syndrome, sprains and strains and a wide range of musculoskeletal pain syndromes. The “instruments” also resemble gua sha tools—handheld flat and comb- or rodlike scrapers. The idea behind the technique, like in the MSN technique, is to create a wound, however small, to marshal the body’s resources for recovery, said Lee.

So if you’ve been suffering with plantar fasciitis with little relief from various remedies, and your traditional Western medical doctor is now recommending corticosteroid shots—or if you’ve been putting up with corticosteroid shots to temporarily relieve the pain—you may want to consult a Chinese medicine specialist or ask for a referral to a physical therapist trained in instrument-assisted soft tissue mobilization. One of these treatments might finally help you really heal and overcome heel pain.