Dry Needling for Plantar Fasciitis: Does It Help Heel Pain?
Updated: Oct 6
Yes. Dry needling can help plantar fasciitis, but the best results usually come from looking beyond the painful heel and addressing the strength, mobility, and muscle issues contributing to the problem.
Key Takeaways
Research shows that dry needling can help reduce pain and improve how your foot feels and functions, especially when it is combined with a broader rehab plan.
Heel pain does not always mean the heel is the only place we need to look. Tight or sensitive calf muscles can limit ankle movement and place more demand on the plantar fascia.
At Phenom Sports and Rehabilitation, dry needling is just one part of the plan. Depending on what we find during your assessment, treatment may also include strengthening, mobility work, home exercises and shockwave therapy.
Table of Contents
Does Dry Needling Help Plantar Fasciitis?
Yes, dry needling can help with plantar fasciitis.
A 2024 review looked at 12 randomized studies with 781 people. It found that dry needling helped reduce pain and improve foot function, especially when it was used alongside other treatments like stretching and exercise.
That doesn’t mean dry needling is a stand-alone fix. If your heel pain has been hanging around for weeks or months, we usually need to look at what’s keeping the area irritated in the first place.
That may mean strengthening, shockwave therapy or adjusting how much stress your foot is taking during walking, running or training.
The 2023 Clinical Practice Guideline for Heel Pain and Plantar Fasciitis gives dry needling a Grade B recommendation.
This means there is moderate evidence behind its use. The guideline recommends dry needling for reducing pain and improving function in people with plantar fasciitis.
How Dry Needling Helps Plantar Fasciitis
First, a quick clarification. There’s nothing being injected during dry needling. We use a very thin filiform needle, so there’s no medication going into the muscle.
The needle is usually placed into areas that feel unusually tight, tender or sensitive.
Clinicians often call these myofascial trigger points.
Once the needle enters the muscle, it gives the tissue a small mechanical stimulus. That sounds technical, but the idea is pretty simple. The needle creates a physical input that can change how the muscle and nervous system respond.
This can cause several effects:
Pain modulation: This changes how the nervous system processes pain signals.
Changes in pain-related chemicals: Dry needling may alter levels of chemicals such as substance P, CGRP, and beta-endorphins, which are linked to pain.
Reduced muscle sensitivity: The treated area may become less tender or sensitive.
Changes in muscle properties: Dry needling may affect how stiff or tense a muscle feels.
Sometimes the muscle reacts with a quick contraction called a local twitch response. This is a short tightening of the muscle around the needle. It can happen during treatment, but it isn’t necessary for dry needling to work.
There’s still more to learn here. Researchers understand several ways dry needling may influence pain and muscle sensitivity, but we don’t have every part of the mechanism figured out yet.
Dry needling is different from acupuncture, although both use thin needles.
What we do know is that dry needling isn’t breaking up scar tissue or releasing the plantar fascia. That’s not what the needle is doing.
The goal is to change pain and sensitivity and improve how the surrounding muscles respond.
Why Your Heel Hurts but Your Calf May Be Part of the Problem
Plantar fasciitis causes pain under the heel, but the calf can also play a role.
The gastrocnemius and soleus are the two main muscles in the calf. They connect to the heel through the Achilles tendon and help control how the ankle moves when you stand, walk and run.
When these muscles are tight, they can reduce ankle dorsiflexion.
Think about what happens if the ankle can’t move forward normally with each step. Your body still has to find a way to keep moving. That can change how force travels through the foot and increase the demand on the plantar fascia.
Limited ankle dorsiflexion is commonly seen in people with plantar fasciitis. One study looked at 254 people with plantar fasciitis. It found that 83% had limited ankle dorsiflexion. More than half also had tightness mainly in the gastrocnemius muscle.
The plantar fascia also works through something called the windlass mechanism. When the big toe bends upward as you push off the ground, the plantar fascia tightens and helps raise the arch. This makes the foot more stable for the next step.
That’s why treatment may include the calf as well as the foot, particularly when tightness in the gastrocnemius or soleus is limiting ankle movement.
Where Do the Needles Go for Plantar Fasciitis?
There isn’t a standard set of plantar fasciitis points that we needle on every patient. The areas treated depend on where the clinician finds tightness, tenderness or myofascial trigger points.
Treatment areas include:
Area | Where it is | Why it may be treated |
|---|---|---|
Gastrocnemius Large calf muscle | Back of the calf | If it is tight or sensitive, it may limit ankle movement and make the foot work harder |
Soleus Deep calf muscle | Under the larger calf muscle | Tightness here may also limit ankle movement during walking and running |
Quadratus plantae Deep foot muscle | Deep in the bottom of the foot | It may develop tight or tender spots that can be treated |
Flexor digitorum brevis Toe-bending muscle | In the sole of the foot | It helps move the toes and support the foot, and it can become tight or sensitive |
Abductor hallucis Inner arch muscle | Along the inside of the foot near the big toe | It helps support the arch and control the big toe, and it can become tight or sensitive |
Medial calcaneal tubercle Inner heel area | On the inside of the heel where the plantar fascia attaches | This is a common spot for plantar fasciitis pain |
So if you come in with heel pain and we spend some of the treatment working on your calf, that doesn’t mean we’re ignoring the painful area. It means we’ve found something farther up the chain that may be contributing to it.
Does Dry Needling for Plantar Fasciitis Hurt?
Dry needling can feel a little uncomfortable, especially when we treat the bottom of the foot. You may feel a small pinch as the needle goes in, followed by some pressure, a dull ache or a quick cramp-like feeling.
Because the foot is more sensitive than the calf, needling around the heel or sole may feel a bit stronger. It’s also normal to feel slightly sore afterward or notice a little bruising. Soreness usually settles within a day or two, while bruising may take a little longer to fade.
And one thing worth knowing. More pain does not mean a better treatment. You do not get bonus points for gritting your teeth through dry needling. It doesn’t have to hurt to work.
What to Expect From Plantar Fasciitis Treatment at Phenom
At Phenom Sports and Rehabilitation, we don’t start with, Where should we put the needles? We start with, Why is this heel still getting irritated?
For one person, limited ankle mobility may be part of the picture. For someone else, it may be calf weakness, doing more running than their body is used to or putting more stress on the foot than it is ready to handle.
That’s why two people with the same diagnosis can walk out with pretty different treatment plans. That difference can also affect cost, since some people may need a combination of treatments.
Treatment can also include:
Calf and foot strengthening
Ankle mobility exercises
Plantar fascia and calf stretching when needed
Balance and stability exercises
Changes to walking, running or training load
A home exercise program
For more stubborn plantar fasciitis, dry needling may also be combined with treatments like Focused Shockwave Therapy when appropriate.
The goal is to reduce pain while helping your foot and ankle get stronger and move better during daily activities and exercise.
They are always so supportive and helpful with everything from my plantar fasciitis... I have sent my best friend here who is also a physical therapist and she absolutely loves their work and how knowledgeable they are. Haley
Wrapping It Up
Dry needling can be a helpful part of plantar fasciitis treatment, especially when tight or sensitive muscles in the calf and foot are contributing to the problem.
But dry needling is usually only one part of treatment. If your ankle is stiff or your foot and calf are weak, those areas may need attention too.
The goal is not simply to calm your heel pain for a few hours. It is to help your calf, ankle and foot work better together so you can get back to walking, running and training without thinking about your heel every step of the way.
At Phenom Sports and Rehabilitation, we offer a free screening appointment to discuss your symptoms, answer your questions, and help you understand your options.
From there, we can move forward with a full assessment to identify what may be contributing to your heel pain and create a treatment plan tailored to your needs.
The focus is on helping you move better, feel stronger, and get back to the activities you enjoy.
Dr. Mark really knows his stuff. He is an expert in identifying the root cause and setting you up for long term success, not just a short term bandaid solution. His focus on manual therapy along with strengthening exercises is a huge plus. Amanda Esselink
FAQ
Does dry needling help plantar fasciitis?
Yes, dry needling can help reduce pain and improve foot function. It tends to work best when it is combined with other treatments like strengthening, stretching and mobility exercises.
Where are the needles placed for plantar fasciitis?
The needles may be placed in the calf, the muscles under the foot or around the heel. The exact areas depend on where your clinician finds tightness, tenderness or sensitive trigger points.
Does dry needling for plantar fasciitis hurt?
You may feel a small pinch, pressure or a dull ache during treatment. The bottom of the foot can feel a little more sensitive than the calf. Mild soreness afterward is also common and usually settles within a day or two.
Why would my calf be treated if the pain is in my heel?
Tight calf muscles can limit how well your ankle moves. This can change the way you walk or run and put more stress on the plantar fascia. That’s why treating the calf can sometimes be an important part of helping heel pain.
Does dry needling break up the plantar fascia?
No. Dry needling does not break up or release the plantar fascia. The goal is to help reduce pain and sensitivity and improve how the muscles around your foot and ankle respond.
External Links
2023 Heel Pain - Plantar Fasciitis Clinical Practice Guideline - Evidence-based recommendations for treating plantar fasciitis, including dry needling.
2024 Systematic Review on Dry Needling for Plantar Fasciitis - A review of 12 randomized studies looking at how dry needling affects pain and foot function.
Cleveland Clinic: Dry Needling - An easy-to-understand overview of what dry needling is, how it works and what to expect.
American Academy of Orthopaedic Surgeons: Plantar Fasciitis - Helpful information about plantar fasciitis, common symptoms and treatment options.
