Effectiveness of Trigger Point Treatment Techniques for Foot Pathologies: A Scoping Review
Abstract
Foot pathologies such as plantar fasciitis and hallux valgus significantly impact patients' quality of life causing pain and mobility limitations. This review explores the clinical application of trigger point treatment techniques, including manual therapy and dry needling, in addressing these conditions. A scoping review following the Joanna Briggs Institute (JBI) methodology was chosen to map the existing literature on trigger point treatments for foot pathologies and identify research gaps. Seven studies were included, evaluating dry needling, dry cupping, and local heating of trigger points. Some improvements in pain reduction and functionality were observed. For example, one study reported an effect size for pain reduction of 0.75 (95% CI: 0.50 to 1.00) with dry needling. Another study found a quality-of-life improvement effect size for percutaneous needle electrolysis at 52 weeks of 0.68 (95% CI: 0.34 to 1.02). Combining extracorporeal shock wave therapy with dry needling significantly improved Visual Analogue Scale (VAS) scores and maximum painless walking distance in another study. While trigger point treatment techniques may offer potential benefits for managing foot pathologies, current evidence is insufficient to draw definitive conclusions. Larger sample sizes and longer-term follow-up studies are needed to strengthen the evidence base and explore safety aspects.
Nakasa T, Ikuta Y, Sumii J, Nekomoto A, Kawabata S, et al. Relationship between pain and intra-articular pathology in patients with chronic lateral ankle instability. Arch Orthop Trauma Surg 2024;144:815-822.
Tedeschi R, Labanca L, Platano D, Benedetti MG. A decision-making tool for prescribing insoles in daily practice using an insole prescription form. J Prosthet Orthot 10.1097.
Tedeschi R. Biomechanical alterations in lower limb lymphedema: implications for walking ability and rehabilitation. Phlebology 2023;02683555231188236.
Tedeschi R. Kinematic and plantar pressure analysis in strumpell-lorrain disease: a case report. Brain Disorders 2023;11:100097.
Tedeschi R. L’impact Biomécanique Des Chaussures de Course Nike Sur Le Risque de Blessures : Une Revue de Littérature. J Traumatol Sport 2023;002.
Tedeschi R. Case study: gait assessment of a patient with hallux rigidus before and after plantar modification. Int J Surg Case Rep 2024;114:109197.
Tedeschi R. An overview and critical analysis of the graston technique for foot-related conditions: a scoping review. Manuelle Medizin 2024;s00337-023-01018-w.
Takabayashi T, Edama M, Inai T, Kubo M. Arch height flexibility is associated with plantar fascia tension during running. Gait Posture 2024;108:270-274. doi:10.1016/j.gaitpost.2023.12.012.
Tedeschi R. What are the benefits of five-toed socks? a scoping review. Reabilitacijos mokslai: slauga, kineziterapija, ergoterapija 2023;1:21-34.
Tedeschi R. Unveiling the potential of trigger point therapy: exploring its efficacy in managing muscular spasticity - a scoping review. Muscles Ligaments Tendons J 2023;13:564-573.
Tedeschi R. Assessment of postural control and proprioception using the delos postural proprioceptive system. Reabilitacijos Mokslai: Slauga, Kineziterapija, Ergoterapija 2023;2:96-112.
De Michele M, Mastrullo M, Melotto G, Tedeschi R. Phlebological insole: can it help in the lymphoedema treatment? a scoping review. Phlebology 2023;38:300-306.
Ghulam HS, Alqhtani RS, Alshahrani A, Ahmed H, Khan AR, et al. Efficacy of cervical mobilization with post-isometric relaxation in managing mechanical neck pain, rom, and functional limitations associated with myofascial trigger points. Medicine (Baltimore) 2023; 102:e36710.
Jenkins LC, Summers SJ, Nasser A, Verhagen A. Dry needling perceptions and experiences: a survey of australian physiotherapists. Musculoskelet Sci Pract 2024;69:102895.
Al-Boloushi Z, Gómez-Trullén EM, Arian M, Fernández D, Herrero P, et al. Comparing two dry needling interventions for plantar heel pain: a randomised controlled trial. BMJ Open 2020;10:e038033.
Kharazmi AS, Okhovatian F, Baghban AA, Mosallanezhad Z, Kojidi MM, et al. Effects of dry needling on symptomatic hallux valgus: a randomized single blind clinical trial. J Bodyw Mov Ther 2020;24:246-251.
Bagcier F, Yilmaz N. The impact of extracorporeal shock wave therapy and dry needling combination on pain and functionality in the patients diagnosed with plantar fasciitis. J Foot Ankle Surg 2020;59:689-693.
Petrofsky J, Laymon M, Lee H. Local heating of trigger points reduces neck and plantar fascia pain. J Back Musculoskelet Rehabil 2020;33:21-28.
AlKhadhrawi N, Alshami A. Effects of myofascial trigger point dry cupping on pain and function in patients with plantar heel pain: a randomized controlled trial. J Bodyw Mov Ther 2019;23:532-538.
Cotchett MP, Munteanu SE, Landorf KB. Effectiveness of trigger point dry needling for plantar heel pain: a randomized controlled trial. Phys Ther 2014;94:1083-1094.
Becerra-Yañez P, Núñez-Cortés R, López R, Ortiz M, Pérez M, et al. Treadmill exercise post dry needling improves heel rise in patients recovering from surgical ankle fracture: a randomised controlled trial. J Bodyw Mov Ther 2023;34:60-65.
Peters: Joanna Briggs Institute Reviewer’s Manual, JBI - Google Scholar Available online: https://scholar-google-com.ezproxy.unibo.it/scholar_lookup?hl=en&publication_year=2020&author=MDJ+Peters&author=C+Godfrey&author=P+McInerney&author=Z+Munn&author=AC+Tricco&author=H+Khalil&title=Joanna+Briggs+Institute+Reviewer%27s+Manual%2C+JBI (accessed on 9 June 2022).
Tricco AC, Lillie E, Zarin W, O’Brien K, Colquhoun H, et al. PRISMA extension for scoping reviews (prisma-scr): checklist and explanation. Ann Intern Med 2018;169:467-473.
Gandolfi M, Geroin C, Valè N, Marchioretto F, Turrina A, et al. Does myofascial and trigger point treatment reduce pain and analgesic intake in patients undergoing onabotulinumtoxina injection due to chronic intractable migraine? Eur J Phys Rehabil Med 2018;54:1-12.
Tedeschi R. Briser Le Cycle Nocebo : Stratégies Pour Améliorer Les Résultats En Podiatrie. Douleurs : Évaluation - Diagnostic - Traitement 2023;24:241-247.
Tedeschi R. Can beneficial frequencies in physiotherapy help treatment? scoping review. Rwanda Med J 2023;80:88-94.
Tedeschi R. Automated mechanical peripheral stimulation for gait rehabilitation in parkinson’s disease: a comprehensive review. Clin Park Relat Disord 2023;9:100219.
Tedeschi R. L’efficacité Des Semelles Posturales Dans La Gestion de La Posture Chez Les Personnes Atteintes de Paralysie Cérébrale : Une Revue de Portée. Motricité Cérébrale 2023.
Labanca L, Tedeschi R, Mosca M, Benedetti MG. Individuals with chronic ankle instability show abnormalities in maximal and submaximal isometric strength of the knee extensor and flexor muscles. Am J Sports Med 2024;52:1328-1335.
Tedeschi R. Reevaluating the drucebo effect: implications for physiotherapy practice. J Psychosoc Rehabil Ment Health 2024;3:391-393
Tedeschi R. Harnessing the drucebo effect: a new frontier in podiatric patient care. J Foot Ankle Res 2025;18:e70029.
Babazadeh-Zavieh SS, Ansari NN, Ghotbi N, Naghdi S, Jafar Haeri SM. Dry needling combined with exercise therapy: effects on wrist flexors spasticity in post-stroke patients - a randomized controlled trial. Neuro Rehabilitation 2024;54:399-409.
De Meulemeester K, Calders P, Cagnie B. Exploring the underlying mechanisms of action of dry needling: what is the immediate effect on muscle electrophysiology? an experimental randomized controlled trial. Am J Phys Med Rehabil 2022;101:18-25, doi:10.1097/PHM.0000000000001732.
Becerra-Yañez P, Núñez-Cortés R, López R, Ortiz M, Pérez M, et al. Treadmill exercise post dry needling improves heel rise in patients recovering from surgical ankle fracture: a randomised controlled trial. J Bodyw Mov Ther 2023;34:60-65.
| Issue | Vol 10, No 4, 2025 -In Press- | |
| Section | Review Article(s) | |
| Keywords | ||
| Trigger point therapy Foot disorders Dry needling Manual therapy Pain management | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |


