Pain relief in plantar fasciitis: phonophoresis versus iontophoresis in guards: a pilot study

Purpose. Plantar fasciitis is a leading cause of heel pain, particularly among individuals engaged in prolonged standing and walking occupations such as security guards. It is now understood as a degenerative fasciosis of the plantar fascia rather than a purely inflammatory condition, involving collagen disorganization and microtrauma at the medial calcaneal 26 management due to their safety and clinical feasibility. Phonophoresis and iontophoresis are commonly used transdermal drug delivery modalities that enhance the local effects of topical agents such as diclofenac through ultrasonic energy and low-intensity electrical currents, respectively. Both techniques aim to provide targeted pain relief while minimizing systemic side effects. Additionally, Muscle Energy Techniques (MET) may further improve outcomes by enhancing flexibility, reducing muscle tightness, and optimizing foot biomechanics. However, evidence comparing the relative effectiveness of phonophoresis and iontophoresis, particularly when combined with MET in occupationally active populations, remains limited. This study, therefore, seeks to address this gap by comparing their effects on pain and quality of life in middle-aged security guards with plantar fasciitis. Objective: to determine Pain Relief in Plantar Fasciitis: Phonophoresis versus Iontophoresis in Guards. Material & Methods. Thirty security guards with clinically diagnosed bilateral plantar fasciitis were recruited using convenience sampling and randomly allocated into two equal groups in a single-blinded manner using an odd–even allocation method. Group A received MET combined with phonophoresis using diclofenac potassium 6% gel, while Group B received MET combined with iontophoresis using diclofenac potassium 6% gel. Both interventions were administered daily for four weeks under physiotherapist's supervision. Pain intensity, foot function, and quality of life were assessed at baseline and post-intervention using the Visual Analog Scale (VAS), Foot Function Index (FFI), and SF-36 Health Survey Questionnaire, respectively. Data were analyzed using IBM SPSS Statistics version 26.0. (IBM Corp., Armonk, NY, USA) Descriptive statistics were expressed as mean ± standard deviation. Normality was assessed using the Shapiro–Wilk test, and as data were normally distributed, parametric tests were applied. Within-group changes were analyzed using paired t-tests, and between-group differences were evaluated using independent samples t-tests. A p-value 0.05). Both groups demonstrated significant within-group improvements in pain (VAS), foot function (FFI), and quality of life (SF-36) following the 4-week intervention (p