RESEARCH PAPER REVIEW: MAY

RESEARCH PAPER REVIEW: MAY

Plantar heel pain is one of the most common foot conditions seen in clinic with plantar fasciitis being a regular diagnosis. Night splints are often cited amongst the regular treatment options for plantar fasciitis in both the medical literature and in patient focussed online articles and blogs. This systematic review aims to evaluate the effectiveness of this conservative treatment in the available literature.

 

"The effect of night splints in the treatment of plantar fasciitis: a systematic literature review"

Boatwright, K., Hutchinson, T., Saurman, A., Méndez, E., Wanyo, C., Howard, P.(2016)

Department of Physical Therapy Capstone Posters. 10. http://jdc.jefferson.edu/dptcapstones/10 

Overview:

This review quotes that plantar fasciitis occurs in more than 2 million Americans every year. Night splints are often prescribed or bought “off the shelf” by patients, but there is little research to validate their effectiveness. At best, some of the evidence suggests that night splints may be helpful in treating the common symptoms of plantar fasciitis”.

What it all means:

Overall, the evidence for the use of night splints for treating plantar fasciitis is low. The papers included in this review only involved 2 RCTs and 4 observational studies and all 6 had short follow ups.  While there appears to be no negative side effects, more comprehensive research is needed.

Key points:

  • 55 papers were identified through a comprehensive data search with just 6 deemed as relevant following evaluation.
    • 2 papers assessed posterior-tension splints to maintain ankle dorsiflexion and toe extension.
    • 1 paper investigated anterior tension splints
    • 1 paper compared anterior and posterior night splints.
    • 1 paper assessed a sock-type night splint.
    • 1 paper assessed a “Dynasplint”
  • “The evidence ranged from high to very low quality”.
  • “The recommendation for use of night splints was weak in all 6 papers”. However, “night splints may be helpful in treating the common symptoms of plantar fasciitis”.
  • Anterior night splints and sock type night splints were generally thought to be more comfortable and therefore patients were more compliant in the 3 papers which investigated these.

Putting it into practice:

  1. Accurate diagnosis of plantar fasciitis is essential for putting together an effective treatment plan. For more information on signs, symptoms and diagnosing, watch our “Plantar Fasciitis Webinar” 
  1. From the limited evidence available, night splints do not appear to have any adverse side effects, so there are no obvious reasons not to use them if you and your patient feel they may help. Anterior splints and sock type splints seem to be better tolerated and more comfortable than posterior night splints.
  1. Always consider the bigger picture. Often one treatment in isolation is not as effective as incorporating other treatments into your overall management plan. For more information on other treatment options for plantar heel pain, read our February 2019 Paper Review

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