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

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Credit to www.lbgmedical.com for this post who have an excellent literature and training library.

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.