Effectiveness of Pulsed Electromagnetic Field Therapy in Patients With Symptomatic Plantar Calcaneal Spurs

This prospective, randomized, sham-controlled clinical trial aims to evaluate the effectiveness of pulsed electromagnetic field (PEMF) therapy in patients with symptomatic plantar calcaneal spurs. A total of 100 participants will be randomly assigned to either an active PEMF group or a sham PEMF group in a 1:1 ratio. Both groups will receive a standardized stretching exercise program. The primary outcome will be the change in morning first-step pain intensity. Secondary outcomes will include foot function assessed using the Foot Function Index (FFI), plantar fascia thickness measured by ultrasonography, and pressure pain threshold measured using an algometer. Assessments will be performed at baseline and at weeks 4, 8, and 12 to evaluate the short- and medium-term effects of PEMF therapy.

\*\*Inclusion Criteria:\*\* * Adults aged 18-65 years. * Heel pain persisting for at least 3 months. * Radiographically confirmed plantar calcaneal spur on lateral foot radiography. \*\*Exclusion Criteria:\*\* * Symptomatic Achilles tendinopathy or retrocalcaneal bursitis. * Partial or complete plantar fascia rupture. * Calcaneal stress or insufficiency fracture. * Heel fat pad syndrome or fat pad atrophy. * Tarsal tunnel syndrome or other peripheral neuropathies. * Foot pain associated with S1 radiculopathy. * Inflammatory rheumatic diseases or gout. * Active infection. * Malignancy. * Severe lower extremity deformity or previous calcaneal/foot surgery. * Corticosteroid or platelet-rich plasma (PRP) injection into the plantar region within the previous 6 months. * Extracorporeal shock wave therapy (ESWT) within the previous 6 months. * Requirement for regular nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesic medication. * Diabetes mellitus. * Significant peripheral vascular disease. * Pregnancy or breastfeeding. * Presence of a cardiac pacemaker or other implanted electronic devices.