# A randomized controlled trial of a supervised self-administered program for chronic plantar fasciitis

## TL;DR

A supervised self-administered program for chronic heel pain showed better pain relief and mobility improvements than a self-care leaflet.

## Contribution

The study introduces a supervised integrated self-administered program for chronic plantar fasciitis with measurable clinical benefits.

## Key findings

- The intervention group showed significantly greater pain reduction and improved mobility compared to the control group.
- Benefits of the program were maintained one month after the intervention ended.
- The program included foot strengthening, stretching, and self-administered massage under therapist monitoring.

## Abstract

Plantar fasciitis (PF) is the most frequent cause of chronic heel pain. Conservative interventions, including strengthening and stretching exercises as well as massage, are commonly recommended as first-line management. However, the effectiveness of an integrated self-administered program (IA) for patients with chronic PF remains unclear. Therefore, this study aimed to evaluate the effectiveness of a supervised IA compared with a self-care leaflet in individuals with chronic PF.

Sixty-four participants with chronic PF (47 females, 17 males)were randomly allocated to either the intervention group (n = 32; mean age 60.3 (SD 3.7) years) or the control group (n = 32; mean age 56.9 (SD 5.4) years). The intervention group engaged in a multi-component program that included foot and ankle strengthening, active stretching, and self-administered Thai massage using a self-treatment stick. The program was performed three days per week for four weeks in a community-based setting under therapist monitoring to ensure safety and adherence. In contrast, the control group received an educational leaflet on self-care. Pain intensity (measured using the visual analogue scale), pressure pain threshold, ankle dorsiflexion range of motion, and foot and ankle ability measure (FAAM) were measured at baseline, at the end of the fourth week (week 4), and one month after the intervention period ended (week 8). The primary outcome for this study was designated as pain intensity.

After adjusting for baseline values, the intervention group demonstrated significantly greater improvements in pain intensity (Mean Difference: − 2.5 [95% CI − 3.5, − 1.5]), pressure pain threshold (5.7 [4.8, 6.6]), ankle dorsiflexion range of motion (5.2 [3.2, 7.3]), and FAAM (15.3 [9.6, 20.9]) compared with the control group (all p < 0.05). These effects were maintained at week 8, indicating sustained benefits of the integrated supervised self-administered program.

This integrated supervised self-administered intervention may serve as a practical and effective approach to self-care in the management of chronic PF.

This study was prospectively registered at Thai Clinical Trials Registry (ID: TCTR20240923001).

The online version contains supplementary material available at 10.1186/s12998-025-00624-w.