Upon visiting the doctor for the first time, most patients who suffer from plantar fasciitis will complain of that stabbing pain produced by the first steps taken in the morning. Plantar fasciitis can become an invalidating condition, especially if no conservative measures are taken. The good news is that the symptoms of this condition can be significantly improved by wearing night splints, allowing you to experience a refreshing level of functionality each and every day.
No more painful feet with night splints
Talking to other patients who have been diagnosed with plantar fasciitis, they will all mention the severe heel pain. Getting out of bed in the morning, they will experience this intense pain with the first steps taken; sometimes, the pain can be so intense, that it resembles a hot spike being driven through the respective heel. With night splints, the pain is reduced in a gradual manner, until it reaches a bearable level or even disappears altogether.
The main benefit of night splints is that they maintain the ankle in a dorsiflexed position, thus allowing for the plantar fascia to remain stretched. As they correct the position of the foot throughout the entire night, it should come as no surprise that they reduce/eliminate the heel pain taken with the first steps in the morning. Moreover, depending on the night splint you will choose to wear, both the Achilles tendon and the calf muscles are going to be stretched as well (these are known to play a role in the appearance of plantar fasciitis).
Is there more than one type of night splints for plantar fasciitis?
There are two main types of night splints recommended for patients who have been diagnosed with plantar fasciitis. The first one is known as the dorsal splint, having a hard plastic support that is found along the shin, reaching as far as the top of the foot. The dorsal splint will maintain the foot in a position of dorsiflexion; at the same time, it is characterized by a high level of comfort, with guaranteed breathability for both the heel and the arch of the foot.
The second type is the boot splint, which as its name clearly points out, resembles a boot. As opposed to the above-mentioned dorsal splint, this particular one is larger in size and might take a longer time to adjust. It is also worth mentioning that one cannot walk while wearing the boot splint. The recommendation on a particular type of splint will be made by a medical specialist.
What are the potential complaints when it comes to night splints?
If the dorsal night splint is not properly designed, it might not hold the ankle in the right position and the foot will slip. Because of that, it is imperative to seek out a specialist that can design a custom-fitted night splint. Another common complaint is the excess pressure on the toes caused by an improper splint; the more you wear an ill-fitted orthosis, the higher the risk of tingling and numbness. Also, if the straps are too large, sweating and subsequent irritation can occur.
The boot splint is more difficult to wear than the dorsal version, because of its size and reduced comfort. Boot splints are large and lack the necessary comfort, presenting an increased risk of numbness. As it was already mentioned, you cannot walk in them, if you have to get up during the night.
If the night splints are equipped with Velcro, these will wear off more quickly. Also, some of the materials that are used for the making of these splints can be quite uncomfortable, causing the skin to heat quite easily. Some night splints will cause the toes to pull back, adding to the already experienced discomfort. However, many of these complaints can be solved by choosing custom-fitted night splints.
Essential characteristics of night splints
The main purpose of a night splint is to relieve the morning pain caused by the inflammation of the plantar fascia. In general, it is recommended to use a night splint that has a lightweight design and a sole that is resistant to slips. The night splint, whether dorsal or boot-like, should keep your foot stretched in a dorsiflexed position and relieve the severe heel pain.
Night splints are equipped with soft padding, in order to keep the risk of irritation down to a minimum. You should choose night splints that fit on both feet, in case the problem is present in both plantar fasciae. Even though padded straps will ensure that your ankle stays in a fixed position, avoid those that are too large in size, as they will not allow the foot to breathe. Some night splints have an optional wedge for toe support, so you might want to discuss with your doctor about such additions to your splints.
The dorsal night splint is more comfortable to wear and also less bulky. Soft foam is often added to provide an increased level of comfort, while allowing the foot to breathe. It is worth mentioning that, unlike the boot splint, the dorsal splint can be used to walk around the house. Some night splints have an adjustable foot strap, which allows for more comfort. These splints are also easier to remove and simple to carry, in case of travels.
In the situation that you have been recommended to wear a boot splint, it is recommended to choose one that has soft padding. This will reduce the risk of irritation during sleep, maintaining your ankle in a functional, dorsiflexed position. The boot splint can be equipped with an optional wedge as well, for an added level of comfort. Modern boot splints have softer profiles, being less intrusive and more comfortable to wear.
Night splints, part of the conservative treatment solutions
According to a doctoral dissertation sustained at the University of Pittsburgh, night splints can be used to reduce the morning pain caused by plantar fasciitis. They can prevent the painful contracture of the plantar fascia, as well as the one present at the level of the Achilles tendon. These are part of the conservative treatment possibilities, along with the medial arch supports.
As the study that was part of the dissertation pointed out, patients with various degrees of passive ankle dorsiflexion can benefit from using night splints. By using night splints during sleep and medial arch supports during the day, patients can benefit from a speedier recovery from the symptoms of plantar fasciitis (the healing process is accelerated).
Another study was undertaken regarding the usage of tension night splints in patients who were diagnosed with plantar fasciitis. The results of the study were published online, on the website of the US National Library of Medicine. The participants to the study were assessed for the symptomatology experienced; apart from the assessment of pain, researchers analyzed the plantar fascial tenderness and the existent range of motion at the level of the ankle.
Tension night splints were demonstrated to be an effective conservative treatment for patients with plantar fasciitis. However, these remain effective in the situation that they are used in conjunction with other treatment solutions, such as heel pads, physical therapy (stretching and strengthening exercises) and non-steroidal anti-inflammatory medication.
A similar study was undertaken years later, reinforcing the idea that night splints are highly effective for patients with plantar fasciitis. The participants to the study were evaluated in terms of heel pain and other symptoms characteristic for this condition, including the presence of calcaneal spurs. The assessments were made with the help of the range of motion scales.
The study demonstrated that, upon wearing custom-fitted night splints, patients with plantar fasciitis experienced significant pain relief. However, these benefits were present only on a short term basis (wearing the night splints on a long term basis did not seem to help those who suffered from chronic heel pain). The study also revealed that other conservative methods were used at the same time with the night splints (which contributes to the idea that the symptoms of plantar fasciitis cannot be improved just by wearing splints).
In an article published online, on LER Magazine, night splints were presented as essential treatment for plantar fasciitis pain. The authors of the article highlighted the fact that plantar fasciitis is one of the most common causes of subcalcaneal heel pain. Limited ankle dorsiflexion is one of the major risk factors for such conditions; the reduced range of motion, in combination with the intense pain, are responsible for the limiting of the physical activity. It was concluded that both dorsal and boot splints can be used in patients who suffer from plantar fasciitis; however, the dorsal night splints are more recommended. Even though these do not stretch the plantar fascia as much as the boot splints, patients are more compliant to using them.
According to an article presented by researchers at the University of Virginia School of Medicine, custom-made night splints are highly efficient when it comes to relieving heel pain. Among the conservative treatments recommended for plantar fasciitis, tension night splints stand at the top of the list. These can maintain the ankle in a dorsiflexed position, as well as keep the toes extended. As the plantar fascia is stretched in a mild and gradual manner, the healing occurs naturally, without too much discomfort.
 National Institute of Health http://www.ncbi.nlm.nih.gov/pubmed/8792046
 National Institute of Health http://www.ncbi.nlm.nih.gov/pubmed/17876122