Alternate hot and cold application in the management of heel pain: A pilot study.

Background: Despite a long-standing tradition of naturopathic physical therapy and hydrotherapy use in the treatment of musculoskeletal conditions, neither naturopathy, nor specific aspects of hydrotherapy have been tested for efficacy in the treatment of heel pain.

Methods: Patients (n=20) were assigned to standard naturopathic physiotherapy care (NPC) with two adjuvant therapy groups: a control group (therapeutic ultrasound, n=10), or alternating compresses (n=10). Pain scores were measured before and after treatment using Visual Analog Scale (VAS) and foot functionality was measured using the Foot Function Index (FFI).

Results: FFI reduced from 46.97 to 31.98 (p=0.005) among normal protocol patients and from 49.72 to 21.35 (p=<0.001) among patients receiving the alternating compress protocol. Average VAS pain intensity in the seven days of treatment decreased from 3.53 to 2.53cm (p=<0.001) among patients receiving NPC and from 4.09 to 2.61cm (p=<0.001) amongst those receiving NPC plus alternating compresses. There was no significant difference in pain score reduction between the two groups (p=0.206), but patients with alternating compresses as part of their treatment had significant improvements in foot functionality (p=0.007).

Discussion: Naturopathic physical therapy significantly improves foot functionality and pain scores in heel pain. Additionally, alternating compresses improve foot functionality scores.