Comparative Efficacy of MLS Laser, ESWT, and Exercise Therapy on Plantar Fasciitis Outcomes: A Randomized Controlled Trial

Background Plantar fasciitis (PF) is a common cause of heel pain in adults. This study aimed to assess the effects of exercise, Multiwave locked system (MLS) laser, and extracorporeal shock wave (ESWT) treatments on pain, functionality, and quality of life (QoL) in PF patients, and to compare the effectiveness of these treatments. Methods Sixty patients diagnosed with PF were randomized into three groups: exercise therapy alone, exercise plus MLS laser therapy, and exercise plus ESWT. Patients were evaluated using the visual analog scale (VAS), foot ankle outcome score (FAOS), foot function index (FFI), heel tenderness index (HTI), and a fall risk analysis before and one month after treatment. Results All groups showed significant improvements in VAS, HTI, FAOS, FFI, and fall risk scores. The laser group demonstrated more improvement in FFI-pain, FFI-total, FAOS-work-daily life, and FAOS-sports-recreation compared to the exercise group. The ESWT group showed more improvement in VAS, HTI, FFI-pain, FFI-total, and FAOS-sports-recreation compared to the exercise group. There was no significant difference between the laser and ESWT groups. Conclusions In conclusion, exercise, exercise with MLS laser, and exercise with ESWT treatments all reduced pain and improved functionality and QoL in PF patients. ESWT and MLS laser therapies, when combined with exercise, provided better overall improvements than exercise alone. Both are cost-effective, accessible, and non-invasive treatment options that can be safely used for PF.