Reflective and Refractive Practice: Lessons from Reviewing Acupuncture for Plantar Heel Pain

Reviews of the use of acupuncture for plantar heel pain reveal great heterogeneity. A wide range of approaches may be subsumed under the rubric ‘acupuncture and related techniques’. Similarly, many different labels have been used for plantar heel pain, some of which may be anachronistic and misleading. Problems of such labelling are discussed, and alternative generalisations considered. A selection of findings from literature reviews is highlighted, including use of ashi points, Taixi KID-3, diagonally opposite points and point combinations. Rationales underpinning these interventions are summarised and mapped. It can be helpful for practitioners to reflect on their own practice in the context of these research findings. A co-constructive approach is recommended and the concept of refractive practice is developed via consideration of ‘whole systems’ and postmodern practice. Illustrative examples of its usefulness are given. The combined use of refraction and reflection is recommended as a tool to enhance theoretical visibility in postmodern practice. Practitioners are encouraged to embrace complexity and heterogeneity, question longstanding assumptions and view clinical phenomena afresh. Questions for future study and for individual reflection are proposed.