Needle–Surface Electroacupuncture for Metatarsalgia and Plantar Fasciitis: A Clinical Case Report

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Abstract

Introduction: Metatarsalgia and plantar fasciitis are common causes of plantar foot pain that can substantially impair function and quality of life. While conservative management is recommended for both conditions, evidence supporting electroacupuncture (EA), particularly for metatarsalgia, remains limited. This case report describes a modified EA technique combining acupuncture needles with adhesive surface electrodes to improve treatment tolerability while maintaining electrical stimulation of the symptomatic region.

Case presentation: A 55-year-old woman presented with persistent bilateral plantar foot pain, clinically diagnosed as left metatarsalgia and right plantar fasciitis. Previous treatment with extracorporeal shockwave therapy and transfer of energy capacitive and resistive (TECAR) therapy failed to improve symptoms. A course of electroacupuncture was initiated. Following poor tolerance of plantar needling, the protocol was modified by replacing plantar needle electrodes with adhesive surface electrodes and changing stimulation from alternating 2/100 Hz to continuous 100 Hz.

Results: By the final session, pain on the Numeric Rating Scale (NRS) had fallen from 8/10 to 1/10 (left) and 7/10 to 3/10 (right), with immediate post-treatment pain completely abolished in both feet. Patient-Specific Functional Scale scores improved from 2–3/10 at baseline to 8/10 after treatment and were maintained at three-week follow-up. The left foot remained pain-free at follow-up, whereas the right foot demonstrated mild activity-related pain associated with occupational loading.

Conclusions: This case suggests that needle–surface EA may represent a feasible and well-tolerated clinical adaptation for patients with plantar foot pain who poorly tolerate repeated plantar needling. Although treatment efficacy cannot be inferred from a single case, the technique warrants further investigation in controlled clinical studies.

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