Plantar Fasciitis: An Integrated Approach Using Acupuncture, PEMF, and Water Filtered Infrared Therapy
What is Plantar Fasciitis?
Plantar fasciitis is one of the most common causes of heel pain. For some people it is a relatively short-lived problem, but for others it can become persistent, affecting walking, exercise, work and everyday activity.
The plantar fascia is a strong band of connective tissue extending along the underside of the foot from the heel towards the toes. It plays an important mechanical role in supporting the arch of the foot and transferring forces as we stand, walk and run.
Plantar fasciitis, also commonly described as plantar heel pain, develops when this tissue becomes irritated, inflamed and painful, particularly around its attachment to the calcaneus, or heel bone.
It is commonly associated with repetitive mechanical loading. Factors that may contribute include prolonged standing or weight-bearing, walking on hard surfaces, inadequate footwear and altered biomechanics. Anatomical and biomechanical factors such as flat or high arches, a tight Achilles tendon, overpronation, weakness of the intrinsic foot muscles and weakness of the plantar flexors may also contribute.
Although heel spurs are often associated with plantar fasciitis, they are not necessarily the cause of the pain. One review cited in the 2024 network meta-analysis found that only 5.2% of people with radiographically identified heel spurs had symptoms of plantar fasciitis.
This is an important distinction: successful treatment is therefore not simply about the presence or absence of a heel spur, but about understanding the tissues, biomechanics and pain mechanisms contributing to the individual presentation.
Common Symptoms of Plantar Fasciitis
One of the characteristic features of plantar fasciitis is pain around the underside and inner aspect of the heel, particularly where the plantar fascia attaches to the calcaneus.
The classic presentation is “first-step pain”, significant heel pain when first getting out of bed in the morning or when standing after a period of rest. The discomfort may then begin to settle after taking several steps.
Other symptoms may include:
- tenderness around the inner or underside of the heel
- pain when weight-bearing
- pain after prolonged standing or walking
- discomfort following exercise or increased physical activity
- stiffness through the foot, ankle or calf
- difficulty returning comfortably to running, sport or regular exercise.
The condition can become surprisingly persistent. A recent randomized trial of people with chronic recalcitrant plantar fasciitis notes that symptoms can continue for years despite treatment, with the condition potentially affecting physical activity, quality of life and disability.
How Can Acupuncture Help Plantar Fasciitis?
Acupuncture offers an interesting approach because it allows us to address both local tissue sensitivity and the nervous system mechanisms involved in pain.
Treatment does not necessarily involve needling directly into the most painful area alone. Depending on the presentation, acupuncture may incorporate local Ashi or tender/trigger points together with points around the foot, ankle and lower leg and distal acupuncture points.
This is distinct from dry needling. Traditional acupuncture incorporates acupuncture points and meridian relationships alongside local Ashi or trigger points, whereas dry needling predominantly focuses on trigger points.
Modulating Pain Signalling
Several mechanisms have been proposed to explain acupuncture’s analgesic effects.
These include activation of endogenous opioid-mediated pain inhibition, engagement of descending pain-modulating pathways historically described as diffuse noxious inhibitory control, and effects on inflammatory signalling.
In practical terms, acupuncture is not simply attempting to temporarily “numb” a painful heel. Needling provides a sensory stimulus capable of influencing how pain signals are processed both locally and within the nervous system.
This may be particularly relevant when plantar fasciitis has persisted for months and pain sensitivity has become part of the ongoing clinical picture.
What Does the Research Show?
The evidence supporting acupuncture in plantar fasciitis has continued to show it is effective in reducing pain and improving quality of life.
A 2024 network meta-analysis examined 32 studies involving 2,390 participants and compared acupuncture with several commonly used non-surgical interventions, including extracorporeal shockwave therapy, ultrasound therapy, corticosteroid injections and platelet-rich plasma injections. At one month, acupuncture produced the greatest reduction in pain relative to placebo among the interventions examined.
Earlier research also produced encouraging findings.
A randomized controlled trial published by Zhang and colleagues examined acupuncture for plantar fasciitis with follow-up extending to six months. Significant differences favouring the treatment acupuncture group were observed at one month for morning pain, overall pain and pressure pain threshold.
More recently, a 2026 randomized controlled trial investigated acupuncture in 120 people with chronic recalcitrant plantar fasciitis — meaning symptoms had persisted for at least six months and had failed to adequately respond to conservative treatment.
After four weeks, 56.7% of participants receiving acupuncture achieved at least a 50% reduction in their worst pain, compared with 33.3% in the waitlist group.
Even more interesting was the apparent relationship between treatment intensity and outcome. By week 16, 76.7% of participants receiving the higher-intensity acupuncture protocol had significant reductions in pain, compared with 36.7% of the waitlist group.
The authors concluded that acupuncture, particularly the higher-intensity protocol, significantly improved pain in chronic plantar fasciitis, with effects sustained through week 16.
An Integrative Approach at Como Health Group
Plantar fasciitis rarely occurs in isolation from the structures surrounding it.
The plantar fascia forms part of a larger mechanical system involving the foot, ankle, Achilles tendon and calf musculature. For this reason, our treatment approach considers the painful heel as well as the tissues and movement patterns contributing to the load being placed through it.
Acupuncture may therefore be combined with other physical therapies available at Como Health Group, including PEMF and water-filtered infrared-A therapy and massage.
The aim is to use complementary therapeutic inputs rather than relying on one modality alone.
Pulsed Electromagnetic Field Therapy – PEMF
PEMF is a non-invasive therapy that exposes tissues to low-frequency pulsed electromagnetic fields.
It has been investigated across a range of musculoskeletal conditions for potential effects on pain, inflammation, circulation and tissue recovery. A 2026 systematic review specifically examining foot and ankle soft-tissue conditions included four randomized controlled trials involving 243 participants. Three of the four studies reported significantly greater reductions in pain in the PEMF groups.
This is an important point: PEMF should not be presented as a stand-alone cure for plantar fasciitis. Rather, we use it as an adjunct to the broader treatment, particularly when addressing painful or irritated musculoskeletal tissue.
PEMF is non-invasive, meaning it can be applied while the patient is resting during treatment and can sit comfortably alongside acupuncture.
Water-Filtered Infrared-A Heat Therapy
We may also incorporate water-filtered infrared-A (wIRA) using our Hydrosun system.
Unlike conventional superficial heating, water-filtered infrared-A is designed to deliver infrared-A wavelengths with relatively high tissue penetration while filtering wavelengths that contribute more strongly to heating at the skin surface.
Research into wIRA has demonstrated that it can increase tissue temperature, tissue perfusion and tissue oxygen partial pressure.
These effects make wIRA particularly interesting as an adjunct when working with musculoskeletal tissues, where circulation and tissue metabolism form part of the recovery environment.
For many patients it also provides a comfortable, warming component to treatment while acupuncture needles are retained.
Bringing the Treatment Together
Persistent plantar fasciitis can be frustrating because simply resting the foot does not always address why the problem developed or why it continues.
At Como Health Group, treatment begins by understanding the individual presentation: where the pain is located, how long it has been present, what aggravates it, the tissues involved and the biomechanical factors that may be continuing to load the plantar fascia.
From there, treatment may combine acupuncture to influence pain processing and local tissue sensitivity, PEMF as a non-invasive adjunct for musculoskeletal pain and tissue recovery, and water-filtered infrared-A to provide therapeutic heat and support local tissue perfusion and oxygenation.
Just as importantly, the longer-term approach may include appropriate advice around activity, footwear, stretching, strengthening and load management.
Rather than treating plantar fasciitis as simply “a sore heel”, the goal is to understand the factors maintaining the condition and create an environment in which pain can settle, movement can improve and the foot can progressively return to normal activity.
References
Asokumaran, I., Verasamy, B. S., Hasan, M. I. B., Wong, D. K. C., Ong, S. S., & Ng, S. C. (2024). Comparative effectiveness of acupuncture versus non-surgical modalities for treating plantar fasciitis: A network meta-analysis. Cureus, 16(9), e68959. https://doi.org/10.7759/cureus.68959
Chia, C. S. M., Fu, S.-C., Ko, V. M.-C., Lai, J. W. H., Zhou, M., Yung, P. S.-H., & Ling, S. K.-K. (2026). The effects of pulsed electromagnetic field therapy on pain and physical functions in patients with soft tissue injuries: A systematic review of randomised controlled trials. Frontiers in Sports and Active Living, 8, 1694944. https://doi.org/10.3389/fspor.2026.1694944
Hoffmann, G. (2007). Principles and working mechanisms of water-filtered infrared-A (wIRA) in relation to wound healing. GMS Krankenhaushygiene Interdisziplinär, 2(2), Doc54.
Wang, W., Kang, J., Wang, X., Zhu, L., Zhou, K., Zang, Z., Jiao, R., Zhang, W., Shi, J., Liu, Y., & Liu, Z. (2026). Efficacy of acupuncture for chronic recalcitrant plantar fasciitis: A randomized trial. Complementary Therapies in Medicine, 97, 103329. https://doi.org/10.1016/j.ctim.2026.103329
Zhang, S. P., Yip, T.-P., & Li, Q.-S. (2011). Acupuncture treatment for plantar fasciitis: A randomized controlled trial with six months follow-up. Evidence-Based Complementary and Alternative Medicine, 2011, 154108. https://doi.org/10.1093/ecam/nep186
