TECAR therapy trial will test whether heat-based rehabilitation adds value in plantar fasciitis
A new randomized trial is setting up a direct comparison between TECAR therapy and a sham procedure in plantar fasciitis, one of the most common causes of heel pain in adults. The study will pair both arms with the same standardized exercise program, a design that should help isolate whether the active energy transfer itself contributes anything beyond exercise and expectation. By using a double-blind, sham-controlled structure, investigators are trying to answer a practical rehabilitation question that matters at the bedside: does TECAR do more than feel like treatment?
The study is registered as a prospective, parallel-group trial at Ankara Etlik City Hospital in Turkey and is not yet recruiting. Enrollment is estimated at 60 adults, with treatment planned over 2 weeks and follow-up extending to 6 weeks after completion. The target population is relatively specific: adults aged 18 to 65 years with at least 3 months of symptoms, tenderness at the medial calcaneal tubercle or first-step morning pain, a pain score of at least 4 on a 10-cm visual analog scale, and plantar fascia thickness of at least 4.0 mm on ultrasonography. Those criteria point toward a clinically meaningful heel-pain cohort rather than a broad musculoskeletal sample.
A sham design built to separate sensation from therapy
The treatment structure is unusually careful for a physical therapy trial. Participants assigned to the experimental arm will receive active TECAR for 15 minutes per session, 5 days per week for 2 weeks, for a total of 10 sessions. The first 5 minutes will use capacitive mode, followed by 10 minutes of resistive mode, delivered with a BTL TECAR Therapy device along the plantar fascia of the symptomatic foot, with attention to the medial calcaneal insertion. Intensity will be adjusted to produce a comfortable, mild thermal sensation without pain.
The comparator is not a no-treatment arm. It is a sham TECAR protocol that uses the same device, probe, conductive cream, session duration, and probe movement technique, with the display kept out of the participant’s view. The device will be switched on and the timer will run, but no therapeutic energy will be delivered. Both groups will also receive the same standardized information that mild warmth may be felt, and all outcome assessments will be performed by a blinded physician not involved in treatment.
That setup matters because TECAR is designed to create a thermal and potentially biological effect through capacitive and resistive energy transfer, but manual contact, warmth, attention, and repeated sessions can all influence pain reporting. If the active arm outperforms sham in this design, the signal will be harder to dismiss as placebo response or therapist contact alone.
Pain, function, and fascia thickness are the endpoints under the microscope
Morning first-step pain sits at the center of the study. Investigators will measure it with a 10-centimeter visual analog scale at baseline, at the end of treatment, and 6 weeks later. Secondary outcomes include general pain intensity, pain during activity, and the Foot Function Index, which captures pain, disability, and activity limitation. The protocol also includes pressure pain threshold, ultrasonographic plantar fascia thickness, and health-related quality of life, a combination that extends beyond symptom scoring and into tissue-level and functional change.
Plantar fasciitis is not just a pain syndrome; it is often linked to degenerative and overload-related changes at the plantar fascia insertion, particularly when symptoms become chronic. Thickening on ultrasound can reflect that local structural burden, although pain severity and thickness do not always track perfectly in individual patients. A therapy that reduces nociception without changing fascia thickness would still be clinically relevant, but a therapy that shifts both pain and ultrasound findings would raise the possibility of a more durable biomechanical or tissue-level effect.
Exercise remains the anchor treatment in both study arms
Every participant will receive the same exercise program, which is appropriate given how frequently plantar fasciitis improves with stretching and strengthening alone. The regimen includes plantar fascia stretching, gastrocnemius and soleus stretching, and intrinsic foot muscle strengthening through short-foot exercises. Stretching is prescribed three times daily, with 10 repetitions held for 10 to 15 seconds, while strengthening consists of 10 to 15 repetitions.
This matters because the protocol is not testing TECAR in isolation. It is testing whether TECAR adds incremental benefit on top of a rehabilitation base that already targets the tissues most often implicated in plantar heel pain. Calf tightness, reduced ankle dorsiflexion, and poor load distribution through the foot can all increase strain on the plantar fascia, so the exercise component is not filler. It is the active conservative treatment backbone against which TECAR must prove its worth.
Why this trial may move the conversation beyond anecdote
TECAR therapy is already being used in rehabilitation settings, but controlled evidence in plantar fasciitis remains limited. The attraction of the modality is straightforward: a non-invasive treatment that may generate comfortable thermal effects while potentially influencing local circulation, tissue extensibility, or pain modulation. Yet without sham-controlled data, it is impossible to know whether reported improvements reflect a true device effect, the exercise program, or the well-known tendency of pain conditions to fluctuate over time.
The inclusion and exclusion criteria suggest an effort to reduce confounding and improve safety. Patients with recent injection therapy, extracorporeal shock wave therapy, or surgery are excluded, as are those with systemic inflammatory rheumatic disease, diabetic neuropathy, peripheral neuropathy, pregnancy, cardiac pacemakers, active infection, open wounds at the treatment site, or another plausible cause of heel pain such as stress fracture, infection, or tumor. Those exclusions will narrow the sample, but they also make the resulting data easier to interpret in uncomplicated plantar fasciitis.
A small but important operational detail is the double-blind format. Participants will not know whether they received active or sham therapy, and the assessor will be blinded as well. In a condition as symptom-driven as plantar fasciitis, where morning pain can be subjective and highly responsive to expectation, that level of masking is essential. If the active arm shows larger gains in the 2-week and 6-week assessments, the trial will have done more than document improvement; it will have shown that the device itself contributes something measurable beyond a carefully standardized exercise program.
The estimated enrollment of 60 patients means this will be an early, relatively modest study rather than a definitive practice-changing trial. The short follow-up also limits any conclusions about durability. Even so, the design is rigorous enough to clarify a narrow but clinically useful question: in patients with chronic plantar fasciitis, does TECAR therapy deliver a real advantage over sham when both groups are treated with exercise?