Acupuncture vs Dry Needling for plantar fasciitis

I’ve been chronicling the treatment of my plantar fasciitis– I badly tore it in a freak accident with bees last August. Making the switch back to more minimalist shoes has probably been the single most helpful thing I’ve done so far to functionally get my foot back to normal. However, I’ve also been seeking out medical treatments to alleviate the pain and scar tissue, namely acupuncture and ART (in combination) with my Chiropractor, Kevin Jones at Chiroplus, and then also dry needling with my PT/runner friend in Tulsa, Terri Cassel. I’m thankful to have these two wonderful healthcare professionals in our area, and I highly recommend them to others! I thought it would be helpful to write a blog about my experience with both, as I’m sure there’s others out there considering these treatment methods and wondering how they compare and contrast.

Acupuncture

I’ve had great success in the past with acupuncture, as I previously blogged about how it kicked an IT band issue and a 2 year Sciatica/pain-in-the-butt issue. My understanding of how acupuncture “works” is that there’s ‘energy pathways/meridians’ running through the body, and they can become ‘blocked’/irritated. Sticking acupuncture needles in different ~peripheral spots along these pathways helps to clear the pathways so the energy/”Qi” can flow. There’s other theories on how it works, like overstimulating the nerves and getting them to “release”… and causing the release of endorphins for pain relief and muscle relaxation.

My experience is that whether acupuncture works for a problem depends on both the problem/severity and also the skill of the practitioner. I remember when I dealt with my hip and right foot stuff (my other foot, not the left foot that has the PF), I had acupuncture done by two practitioners– a chiropractor in Indiana who was not-so-good and then my “magic man”, Dr. Harold Owens (rest in peace), who was the best acupuncturist I’ve worked with. I got some relief, but I could tell both problems were still there. This indicated to me that I had a serious problem– I ended up getting hernia surgery in 2010, while we were able to kick my labral tear pain with a diagnostic amount of cortisone and rest. These were problems that not even Dr. Owens could kick!

As far as my current plantar fasciitis problem, I’ve been seeing Dr. Kevin Jones in Oklahoma City, who does both acupuncture and ART together. I previously wrote about getting ART treatments with Kevin last spring (my other foot). To describe a typical treatment, Kevin inserts the thin needles peripherally around the painful knot on my heel (feels like a prick, like if you got a shot or blood draw). I lay there quietly/relaxed for ~10 min., he might tap the needles to stimulate them, and as he describes it it causes the area to relax, release endorphins, and increase blood flow and healing of the area. For the most part, it’s a pleasant experience and not very painful/squeamish. Then he removes the needles and performs ART, to hopefully get a myofascial release of the scar tissue.

My experience in the past is that I could be cured with 1-3 acupuncture treatments. I’ve seen Kevin at least 10 times (2x/week for 45 min. per treatment), and while I always feel pain relief, only about 3 out of the 10 times have I felt a significant myofascial release. This indicates to me that either 1) Running is continuing to mechanically irritate the area and prevent it from fully healing, which may mean the need to rest and/or 2) I need more direct, aggressive treatment to stimulate the scar tissue area and get it to heal properly.

Most definitely, my PF is not just a “pain problem” that can be successfully treated with a few acupuncture treatments– there’s significant scar tissue (although it’s shrinking) that needs a direct, aggressive treatment approach. As I’ve mentioned in past posts, each person’s case of PF is different. Each person needs to figure out for themselves, through trial and error, what treatment(s) work the best. For someone who has a less severe case of PF (and not pushing their body like I do!), the combination of acupuncture with ART might be totally effective. However, given the severity of my PF, I decided to give dry needling a try, since it’s more direct and aggressive.

Dry Needling

Contrary to the “peripheral” application of acupuncture needles, dry needling works by sticking acupuncture needles (which Terri says are the same gauge/size as acupuncture needles) directly into the sore area and trigger points of the muscles (~nerve bundle), to get the nerve/muscle to release/relax and stimulate blood flow and healing of the area. Most people have likely heard of “trigger point therapy”, whereas a massage therapist applies external, manual pressure or you might do so on yourself at home. Dry needling does the same thing… except sticking needles directly/internally into the trigger points! It’s called “Dry” needling because whereas ~prolotherapy/PRP injects some type of fluid into the area, dry needling doesn’t.

Additionally, whereas acupuncture needles are inserted all over and I lay there quietly/relaxed for 10 min… with the dry needling, Terri inserts the needle into the trigger point and wiggles/pecks/flosses around for ~30 seconds. It’s much more squeamish and feels weird! I might feel the muscle twitch and release or feel a zing. Also, acupuncture needles don’t go very deep– with the dry needling, Terri inserts the needle all the way to the bone, so much deeper and direct!

For my plantar fasciitis, Terri decided to work both my calf (which she says is tight) and also my foot. As she pointed out, working the calf for some reason leaves you feeling VERY SORE/cramped… like there’s no way you could go run after getting dry needling done on your calf, but you’ll be fine the next day. However, working the heel is one of the most painful areas in the body (heels and palms), but after the treatment you’re not as sore (as the calf!) and actually should feel better.

I’ve seen Terri twice so far, once/week (she’s up in Tulsa, 1:50 from us). Dry needling is usually done by a PT and is a fairly new procedure. While searching around the net trying to find a practitioner in our area, I found one local guy who does it… but he’s out-of-network on our insurance! It was by chance that I decided to contact Terri, since I know her, and found out she not only does dry needling but is also covered by our insurance! If you’re looking for someone in your area who does this, ask around to other runner friends and PTs. You might have to drive a distance, since not as many practitioners do it.

As far as the effectiveness of dry needling, I most definitely felt like it helped my foot to “release” and be in less pain. I did a hard workout 2 days after treatment, 16 x 90 seconds, and it was the best my pushoff has been– definitely more power and fluidness in my gait. My foot didn’t poop out and get sore during the workout… but it did get sore during my cooldown (~running more on my heels).

On the second treatment (Terri worked more directly on the spot that bothers me), she mentioned that she feels a “softness” on my heel and thick scar tissue when she inserts the needles. I told her the MRI back in January showed edema outside the bone and within the bone, along with thick scar tissue. My theory is the lingering scar tissue is continuing to “bruise” and irritate the bone/nerves and create edema, which is why I tend to get sore landing moreso on my heels (as I mentioned with all the downhill running at Two Oceans, or getting sore on my cooldown). Terri recommended that I try A-stim or Graston next (Edit: A-STYM), to see if we can get rid of the scar tissue. I’m trying A-stim next week with Terri’s co-worker, so this might be a future post! I’ve also thought about taking a rest at some point soon, to see if we can get the edema to subside and allow the area to fully heal.

In conclusion, you can try for yourself on whether acupuncture, dry needling, or both in combination provide the needed relief for plantar fasciitis or another injury. If anyone has questions or feedback, feel free to comment!


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Comments

  1. Glad you are doing better. I believe Terri uses Kinetacore as her dry needling technique which emphasizes the “pistoning” of the needle in and out. Integrative Dry Needling does not really use this pistoning. Both are beneficial, but the pistoning is typically far more uncomfortable. For the squeemish, pistoning is typically not used. IASTM,GRATON, and FAKTR can all create an inflammatory process that produces effective healing. FAKTR is probably the best in this regard as eccentric loading can be introduced which increases fibroblastic proliferation considerably. Great post! Another thing worth mentioning would be overloading of the calves due to neural inhibition of another muscles/ or muscles that either work synergistically or antagonistically with the calves. The most important muscles that I find inhibited in PF cases are the glute maximus, and psoas. Enjoy the IASTYM, it should work better than your wrench! ; )

    • and from what I hear, you’re in very good hands. Terri does great work from all I hear!

      • runcamille says:

        Ahhh, Ok, thanks for the description and information Chris! I’m coming to you next, depending on how I respond to the A-STYM! I had been doing heel drops while pressing against our treadmill console to get an essentric stretch and myofascial release. It helped some, but I think I need someone else to manually work on me. My butter knife isn’t getting it done! I’ve been rolling my hamstring/butt with my new Roll Recovery, and it feels good!

  2. Very good piece of information acupuncture and dry needling.

  3. Douglas Lee says:

    First off, I just want to say. This is all great information ! I feel like there should be a P.F. support group. My situation has been dragging on for about two years. First my Rt. foot ( lasted for approx 1year ) and now for the past 10 to 12 months, my left foot is the problem child.

    I use a hard rolling pin, I set it on the floor and sit in a chair and apply direct presure downward onto the inflamed area. I can roll (slow) and feel the knot. (scar tissue) sometimes I can totally disperse the knot and be pain free for an hour or two.

    My question is { do you think I am doing more damage than good } should I not be so agressive with this scar tissue ? Im just not kicking it this time….. my ins. wont cover the treatments that you are speaking about. Just looking for tips.

    Thanks
    Douglas Lee

    • runcamille says:

      Hi Douglas! As I found out with myself, I seemed to have been doing more harm than good with my self-massage tools! I’ve learned since going to the PT, who’s doing A-STYM right now, that I was being too aggressive. They just do a few strokes on me with their tools, twice a week, and it’s helping A LOT.

      I’m going to blog about A-STYM. I think there’s a website where you can find a provider in your area?? This has proven even more helpful that the dry needling! It should be covered by insurance too.

  4. It is good to know that you’re getting better… I had PT for my PF but it didn’t work so I switched to stem cell therapy. I had a 3-week therapy with my ortho surgeon, Dr Grossman of Stem MD and it was successful. I just don’t have much patience for natural and home remedies… I always trust medical science as it can give faster relief. I hope you will be able to fight PF too.

  5. Forest Runner says:

    Camille, it is great that you are seeing positive results, share your successes and want to support your friend. If you want lasting results, not only from the PR but from hernias and other muscle and ligament injuries, find a Licensed Acupuncturists who is fully trained in herbal formulas. Acupuncture, by any name, including Dry Needling (which was written about in the year 609 AD!) is great but you clearly are suffering from a deeper problem and that is why you not only can not get rid of the PR permanently but have had a number of related issues. NCCAOM.org is a site where anyone can find a local listing of Board Certified Licensed Acupuncturists (with 3,000 or more hours of training JUST in acupuncture & Oriental Medicine.) To truly compare acupuncture, by any name, you may want to find someone FULLY trained in it verses 10 to 100 hours.

    I know a number of professional athletes who SECRETLY use Licensed Acupuncturist due to the edge it gives and significantly reduces injuries.

    Good luck in your running career, Camille! We will be cheering for you!

    • runcamille says:

      Hi Forest Runner, thanks for the feedback. All of my injuries the past 10 yrs have been from freak accidents- how many people step on multiple bees and tear their PF?! I’m over the PF now- Birkenstocks were the one thing that finally worked out the last bit of tightness. I used to see a licensed acupuncturist- he was the best, but he passed away. As an elite, I have to be careful with taking any supplements cause they are unregulated by the FDA. I’m doing great right and getting back on track!

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  1. [...] I had tried both acupuncture and dry needling for my plantar fasciitis (which you can read about here ). Following the dry needling, my PT Terri Cassel (and her co-worker, John Tunnel, who’s [...]

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