The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: randomized participant blind controlled trial.

There was no control group, so the isolated effect of laser cannot be separated from patient education and self-care advice. The same physician delivered treatment and carried out evaluations, and that physician knew the allocation, so outcome ratings could be influenced. Follow-up was short, only four weeks, so longer-term effects are unknown. The authors reported high loss to follow-up, and the four-week table lists 30 LLLT participants and 32 HILT participants. All participants received the same education and self-care measures, so laser cannot be credited alone.

Do not conclude that laser therapy alone reduced plantar fasciitis pain. Every participant also received patient education and was told to avoid anti-inflammatory drugs, to ice the heel if pain increased, to wear shoes with a soft pad or silicone insole, to raise heel height from 0 to 5.08 cm, to avoid barefoot walking on firm surfaces, to do foot sole massage, and to do first metatarsal and ankle exercises. The trial had no control group, so the contribution of laser cannot be separated from these measures. Do not choose HILT over LLLT based on the participant rating difference, because the primary pain outcomes did not differ and the average participant rating did not differ significantly.