Comparison of Manual Therapy and Ultrasound in plantar fasciitis: A Systematic Review

Physiotherapy

Introduction: Plantar fasciitis (PF) is a leading cause of chronic heel pain. Physiotherapy is central to its conservative management, and two frequently used modalities are manual therapy (MT) and therapeutic ultrasound (US). However, comparative evidence remains inconsistent. A systematic review was conducted of articles published between 2010 and 2025 using PubMed, Scopus, and Google Scholar. Fifteen relevant randomized controlled trials (RCTs), systematic reviews, and meta-analyses meeting inclusion criteria were analysed for sample size, method, and outcome measures. Manual therapy demonstrated superior short-term pain relief and functional improvement compared to ultrasound. Ultrasound showed moderate benefit mainly as an adjunct to exercise or stretching. Imaging studies reported reduced plantar fascia thickness following MT. Both MT and US are effective in PF management, but MT produces faster and more consistent outcomes. Further standardized RCTs are required to establish clear comparative guidelines. Keywords: Plantar fasciitis, Manual therapy, Therapeutic ultrasound, Pain, Physiotherapy, Rehabilitation

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