A double-blind, randomized, placebo-controlled study assessing polarity-analysis-guided individualized homeopathic therapy for chronic primary heel pain in adults.

Background: Chronic primary heel pain is a debilitating condition that significantly restricts mobility and daily activities. Despite conservative treatments providing only modest long-term benefits in the context of high chronicity, individualized homeopathic medicines (IHMs) show preliminary promise. However, the clinical efficacy of polarity analysis (PA), based on Boenninghausen’s method, a refined repertorization method enhancing precision in prescription, remains unevaluated in this condition. Methods: In this double-blind, 2:1 randomized, placebo-controlled trial (n = 74), PAderived IHMs, selected from Boenninghausen’s module (requiring ≥5 polar symptoms and ≥10 potentially relevant remedies), were compared against placebo over 3 months. The primary outcome was the Foot Function Index (FFI) total score (comprising pain, disability, and activity-limitation subscales); the secondary outcome was the Measure Yourself Medical Outcome Profile (MYMOP2). Intention-to-treat analysis employed Functional Data Analysis (FDA) with B-spline smoothing and permutation tests for recovery trajectories, Generalized Estimating Equations (GEE) adjusted for baseline covariates, and Multivariate Linear Mixed Models (MLMM) for group differences. Results: FDA showed monotonic improvement with IHMs versus flat placebo trajectories, diverging by week 3 (p < 0.001). GEE found the placebo ended 55.03 FFI points higher (p < 0.001). Findings were consistently robust across sensitivity tests and subgroups. Bryonia alba (n = 13, 17.6%), Sulphur (n = 8, 10.8%), and Calcarea carbonica (n = 8, 10.8%) were the most frequently used IHMs. The five most effective remedies were Calcarea carbonica, Bryonia alba, Rhus toxicodendron, Causticum, and Staphysagria macrosperma. Conclusion: IHMs guided by PA demonstrated superior and clinically meaningful recovery compared with placebo in patients with chronic primary heel pain.