Plantar Fasciitis and the Effectiveness of Nights Splints



As a Conservative, Economical First Step...

Abstracts from leading publications on the effectiveness
of Plantar Fasciitis Night Splints in treatment programs.


Overview


Study after study demonstrates night splints are effective in a majority of cases. Often the pain and discomfort of the morning's first steps are significantly reduced or eliminated altogether.

Night splints are an effective, conservative and economical adjunct to effective plantar fasciitis treatment programs.



Plantar Fasciitis & the Effectiveness of Night Splints


Barrett, Stephen L. and O’Malley, Robert. "Plantar Fasciitis and Other Causes of Heel Pain”. American Family Physician. April 15, 1999.

A conservative treatment method, night splints prevent contraction of the plantar fascia during sleep. One study shows relief of associated symptoms in 83% of patients treated with night splints.


Barry, L.D., Barry, A.N. and Chen, Y. "A Retrospective Study of Standing Gastrocnemius-soleus Stretching Versus Night Splinting in the Treatment of Plantar Fasciitis". Journal of Foot & Ankle Surgery July/August 2002; 41(4): 221-227.

Discusses a study in which patients were divided into two groups, one stretching and the other utilizing prefabricated night splints. When compared to the stretching group, the night splint group had a significantly shorter time to recovery and fewer follow-up visits to recovery. It was concluded that as part of an early treatment approach, the night splint helps speed time to recovery.


Batt, M.E., Tanji, J.L., and Skattum, N. "Plantar Fasciitis: a Prospective Randomized Clinical Trial of the Tension Night Splint". Clinical Journal of Sports Medicine July 1996; 6(3): 158-162.

A limited patient study dividing patients into two groups. One group was treated with standard methods of anti-inflammatory medication, a heel cushion and a stretching program. The second group underwent the same treatment as the first group plus received a posterior splint to be worn at night. Study revealed that a night splint is effective in treating of plantar fasciitis, especially when used in combination with other non-operative treatment methods.


Haddad, Jack and Jo, Jeannie. "Heal the Heel". OrthoKinetic Review. September/October 2003: 26-27.

Conservative and non-invasive methods are the mainstay of treatment for plantar fasciitis. Several studies evaluating effective plantar fasciitis treatment with night splints are cited within the article. In one study, 80% of patients completing a night splint study saw improvement. In another limited patient study, symptoms were resolved for the majority of patients with night splinting within the 4 month study duration.


Herring, Kirk M. "Plantar Heel Pain: How To Get Treatment Results". Podiatry Today. May 2003; 16(5): 58-65.

More than 2 million Americans are treated for plantar fasciitis each year. Most specialists agree that plantar fasciitis is successfully treated with conservative methods in the majority of cases. Night splints, along with other conservative approaches, are mentioned as treatments forming the cornerstone for successful management of the condition.


Jimenez, A. Louis and Goecker, Robert M. "Night Splints: Conservative Management of Plantar Fasciitis". BioMechanics. September 1997.

Reviews several studies suggesting that night splints are effective in conservative, plantar fasciitis treatment. One mentioned study divided patients into two groups, a "night splint" group and the control group which was treated with conservative modalities other than night splinting. The control group had success in only 35% of patients while the group treated with night splints had a 100% response. Control group patients who did not respond to their treatment approach were then put in night splints. 72% of those patients had resolved pain after being placed in night splints.


May, Todd J., Judy, Tom A., Conti, Michael E., Cowan, James E. "Current Treatment of Plantar Fasciitis". Current Sports Medicine Reports. October 1, 2002; 1(5): 278-284.

Article defines plantar fasciitis and includes information on anatomy, predisposing factors, and conservative non-invasive treatment options. Complaints of heel pain and plantar fasciitis are commonly seen by primary care providers see. Authors describe a conservative treatment regimen which includes the use of a night splint.


McCurdy, Brian. "Heel Pain Study: Night Splints In, Stretching Out?". Podiatry Today . November 2002; 15(11): 8-14.

Summarizes a recent study which suggests prefabricated night splints offer better results in plantar fasciitis symptom relief than the often recommended stretching approach. Patients were divided into two groups, one group performing standing stretching and one given prefabricated night splints. Patients using the night splints had resolved symptoms in one-third the time of the stretching group. Mean recovery time was 18.5 days for night splint patients compared to 58.6 days for those performing stretching. It is also noted that fewer follow-up visits and fewer additional treatments were required by the night splint group than the stretching group. One DPM mentioned in the article praised the study and was quoted as saying "Prior to reading this article, I favored stretching. Now I will include night splints in addition to stretching".


McGarvey, W.C. "Heel Pain: Front Line Management of a Bottom Line Problem". Journal of Musculoskeletal Medicine. April 1998; 15(4): 14-16, 21-23.

Provides information on heel pain and its causes and evaluation of pain. Includes conservative treatment recommendations. Article states that most cases of plantar fasciitis can be conservatively treated with night splints, stretching, icing, and anti-inflammatory drugs.

Milne, Leslie. "Plantar Fasciitis". www.emedicine.com. July 13, 2001.

The most common cause of inferior heel pain is plantar fasciitis. As part of outpatient care, the use of a night splint which keeps the foot in 5º dorsiflexion is recommended for stretching the fascia while sleeping. Reports the cure rate with a night splint at 80% within 4 months. Night splints are helpful with recalcitrant plantar fasciitis.


Mizel, M.S., Marymont J.V., and Trepman E. "Treatment of Plantar Fasciitis with a Night Splint and Shoe Modification Consisting of a Steel Shank and Anterior Rock Bottom". Foot & Ankle International. December 1996; 17(12): 732-735.

A patient study treated plantar fasciitis sufferers with a combination of a night splint and a shoe modification consisting of a steel shank and anterior rocker bottom. At the 16 month follow-up, 59% had resolved symptoms and an additional 18% had improved. This method of treatment was determined to be effective.


Powell, M., Post, W.R., Keener, J., Wearden, S. "Effective Treatment of Chronic Plantar Fasciitis with Dorsiflexion Night Splints: A Crossover Prospective Randomized Outcome Study". Foot & Ankle International. January 1998; 19(1): 10-18.

A limited study of patients with a history of heel pain for more than 6 months. All were given night splints. In the first month, only the first group wore night splints. Only the second group wore night splints for the second month. Significant improvement was noted in the first group at the end of the first month. Patients in the second group did not experience significant improvement by the end of the first month but did see improvement in their period of splint wear. There was no prescription of other medications, stretching, or strengthening exercises during the study. 88% of patients saw improvement by the end of the six month study. Results showed significant improvement for patients in both groups during splint wear period.


Probe, R.A., Baca, M., Adams, R., and Preece, C. "Night Splint Treatment for Plantar Fasciitis: A Prospective Randomized Study". Clinical Orthopedics and Related Research. November 1999; (368): 190-195.

A limited patient study was performed to determine night splint therapy effectiveness in plantar fasciitis treatment. One patient group used a dorsiflexion night splint for 3 months. 68% reported significant improvement of their condition with this non-invasive treatment in the 12 week study duration.


Quaschnick, M.S. "The Diagnosis and Management of Plantar Fasciitis". Nurse Practitioner. April 1996; 21(4): 50-54, 60-63.

10% of running injuries seen are attributed to plantar fasciitis. It is commonly seen in middle-aged individuals, the elderly population and athletes.


Ryan, J. "Use of Posterior Night Splints in the Treatment of Plantar Fasciitis". American Family Physician. September 1, 1995; 52(3): 891-898, 901-902.

Night splints can prevent the need for invasive treatments (i.e., surgery, injections) for patients unresponsive to methods such as stretching, strengthening, etc.


Shea, Michael and Fields, Karl B. "Plantar Fasciitis, Prescribing Effective Treatments". The Physician and Sports Medicine. July 2002; Vol. 30 No. 7.

Important facts in the article include: more than 90% of athletes respond to conservative methods, more than 2 million Americans receive treatment annually for plantar fasciitis, the condition is one of the most common overuse injuries and one of the most common disorders experienced by those in running and jumping sports. The article summarizes the results of two limited patient studies evaluating the use of night splints. In one study mentioned, the effectiveness of night splints in relieving pain due to plantar fasciitis was compared to other conservative methods. The control group received conservative therapy other than night splints. The study group received the same conservative treatment methods plus night splints. All patients using the night splints improved (average treatment time was 12 1/2 weeks).


Singh, Dishan, Angel, John, Bentley, George and Trevino, Saul G. "Fortnightly Review: Plantar Fasciitis". British Medical Journal. July 19, 1997; 315: 172-175.

Treatment with night splints is recommended soon after the onset of plantar fasciitis symptoms. The cycle of tightening and contracting of the fascia should be interrupted by using a night splint as soon as possible. Most patients notice a considerable reduction in morning pain with the use of a night splint. A study is cited in which 79% of patients were cured after using a night splint for 4 months on average. The condition is bilateral, or occurring in both feet, in up to 15% of patients.


Sobel, Ellen, Levitz, Steven J. and Caselli, Mark A. "Orthoses in the Treatment of Rearfoot Problems". Journal of the American Podiatric Medical Association. May 1999; 89(5): 220-233.

Article discusses several studies in which "posterior night splints", in conjunction with other conservative treatments for plantar fasciitis, have proven effective. In most conditions involving the rearfoot, including plantar fasciitis, orthotic management is beneficial.


Wapner, Keith L., Sharkey, Peter F. "The Use of Night Splints for Treatment of Recalcitrant Plantar Fasciitis". Foot & Ankle December. 1991; Vol. 12 No. 3.

Summarizes a limited patient study supporting the use of night splints. Patients suffering from recalcitrant plantar fasciitis, having symptoms of plantar fasciitis for greater than one year, were provided with an ankle-foot orthosis in 5º of dorsiflexion for use as a night splint. None of the patients had responded to previous treatment methods. During the three month period, patients wore the night splints only while sleeping and removed the splints immediately upon waking up in the morning. After three months, the patients were slowly weaned off their splint. With night splint use, 78% of the patients had complete resolution of plantar fasciitis symptoms in less than four months with no notice of recurrence. Each case noted prompt relief of morning pain. The splint’s ability to resist contracture of the plantar fascia is the main reason it is successful. Using a night splint offers a low-risk treatment alternative with proven success.


Young, Craig C. "Plantar Fasciitis". www.emedicine.com. May 6, 2002.

Article examines plantar fasciitis and associated symptoms, causes, risk factors and treatment options. Cites plantar fasciitis being among the top five most common foot and ankle injuries encountered by professional athletes. Discusses the use of a night splint as a treatment option during the recovery phase. Approximately 80% of patients using night splints improved. Splints are especially useful for individuals having symptoms of plantar fasciitis for an extended period of time.


Young, Craig C. and Neidfeldt, Mark W. "Plantar Fasciitis is a Common Cause of Heel Pain". American Family Physician. February 2001.

Discusses causes and symptoms of plantar fasciitis and the use of night splints for treatment. After wearing a night splint, approximately 80% of patients improved, according to several studies. Night splints are helpful in treating patients having plantar fasciitis symptoms present for longer than 12 months.


Bibliography


Barrett, Stephen L. and O’Malley, Robert. "Plantar Fasciitis and Other Causes of Heel Pain". American Family Physician. April 15, 1999.

Barry, L.D., Barry, A.N. and Chen, Y. "A Retrospective Study of Standing Gastrocnemius-soleus Stretching Versus Night Splinting in the Treatment of Plantar Fasciitis". Journal of Foot & Ankle Surgery. July/August 2002; 41(4): 221-227.

Batt, M.E., Tanji, J.L., and Skattum, N. "Plantar Fasciitis: A Prospective Randomized Clinical Trial of the Tension Night Splint". Clinical Journal of Sports Medicine. July 1996; 6(3): 158-162.

Haddad, Jack and Jo, Jeannie. "Heal the Heel”. OrthoKinetic Review. September/October 2003: 26-27.

Herring, Kirk M. "Plantar Heel Pain: How To Get Treatment Results". Podiatry Today. May 2003; 16(5): 58-65.

Jimenez, A. Louis and Goecker, Robert M. "Night Splints: Conservative Management of Plantar Fasciitis”. BioMechanics. September 1997.

May, Todd J., Judy, Tom A., Conti, Michael E., Cowan, James E. "Current Treatment of Plantar Fasciitis". Current Sports Medicine Reports. October 1, 2002; 1(5): 278-284.

McCurdy, Brian. "Heel Pain Study: Night Splints In, Stretching Out?". Podiatry Today. November 2002; 15(11): 8-14.

McGarvey, W.C. "Heel Pain: Front Line Management of a Bottom Line Problem". Journal of Musculoskeletal Medicine. April 1998; 15(4): 14-16, 21-23.

Milne, Leslie. "Plantar Fasciitis". www.emedicine.com. July 13, 2001.

Mizel, M.S., Marymont J.V., and Trepman E. "Treatment of Plantar Fasciitis with a Night Splint and Shoe Modification Consisting of a Steel Shank and Anterior Rock Bottom". Foot & Ankle International. December 1996; 17(12): 732-735.

Powell, M., Post, W.R., Keener, J., Wearden, S. "Effective Treatment of Chronic Plantar Fasciitis with Dorsiflexion Night Splints: A Crossover Prospective Randomized Outcome Study". Foot & Ankle International. January 1998; 19(1): 10-18.

Probe, R.A., Baca, M., Adams, R., and Preece, C. "Night Splint Treatment for Plantar Fasciitis: A Prospective Randomized Study". Clinical Orthopedics and Related Research. November 1999; (368): 190-195.

Quaschnick, M.S. "The Diagnosis and Management of Plantar Fasciitis". Nurse Practitioner. April 1996; 21(4): 50-54, 60-63.

Ryan, J. "Use of Posterior Night Splints in the Treatment of Plantar Fasciitis". American Family Physician. September 1, 1995; 52(3): 891-898, 901-902.

Shea, Michael and Fields, Karl B. "Plantar Fasciitis, Prescribing Effective Treatments". The Physician and Sports Medicine. July 2002; Vol. 30 No. 7.

Singh, Dishan, Angel, John, Bentley, George and Trevino, Saul G. "Fortnightly Review: Plantar Fasciitis". British Medical Journal. July 19, 1997; 315: 172-175.

Sobel, Ellen, Levitz, Steven J. and Caselli, Mark A. "Orthoses in the Treatment of Rearfoot Problems". Journal of the American Podiatric Medical Association. May 1999; 89(5): 220-233.

Wapner, Keith L., Sharkey, Peter F. "The Use of Night Splints for Treatment of Recalcitrant Plantar Fasciitis". Foot & Ankle. December 1991; Vol. 12 No. 3.

Young, Craig C. "Plantar Fasciitis”. www.emedicine.com. May 6, 2002.

Young, Craig C. and Neidfeldt, Mark W. "Plantar Fasciitis is a Common Cause of Heel Pain". American Family Physician. February 2001.





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