How do Night Splints Help with Morning Plantar Fasciitis Pain?

Night Splints for Plantar Fasciitis

Night splints are undoubtedly one of the safest methods; it is a valuable tool to fight against painful heel due to plantar fasciitis. Most doctors would use it along with other medical therapies to get optimal results. Clinical research leaves little doubt about the effectiveness of night splints. Although, some people may need time getting used to them. Not everyone may like wearing them before going to bed. However, efforts are worth it, as you will feel the benefit in a few weeks.

The primary purpose of wearing night splints is to keep plantar fascia elongated. It also helps extend triceps surae, Achilles tendon, and all the related musculature. The final result is reduced stress on calcaneal tubercle- a place where plantar fascia is attached to the heel bone.

Plantar fasciitis is the result of months/years of neglect, overuse, overstressing of feet. It causes tension and tenderness in the plantar fascia. Purpose of using night splints is two-fold in the condition. Firstly, to reduce the morning pain in the heels in a short time. Secondly, to get a long-term relief and a reduction in the inflammation.

Night splints are rarely if ever used alone. Usually, a specialist will use multiple therapies in combination to achieve sufficient beneficial effect in the shortest possible time. Thus anti-inflammatory drugs will be prescribed in all the cases. Stretching exercises, use of shoe pads, corticosteroid injections in the heel are some of the other approaches.[1]

Despite the reputation of night splints, there is little agreement among the specialists regarding their role in the treatment. Some doctors would recommend their use immediately, while others may include them in a therapeutic complex sometime later. American physical therapy association recommends that night splints should be used daily for one to three months, to feel the effect. They may be used even longer in some cases.[2]

How Exactly Can Night Splints Help in Plantar Fasciitis?

If stretching exercises are an active way of increasing length of plantar fasciitis, then night splints are a passive way of doing it. Together they work more effectively, as one method is used during the day when a person is awake, while another method when asleep.

When we sleep, muscle tone in the lower leg causes our feet to point downward. The result of this condition is that over the time plantar fascia, related muscles, get shortened. This shortened plantar fascia is more prone to damage, wear and tear under the physical stress. It results in sharp pain when a person starts walking after a prolonged rest.

So what night splints do is that they keep the feet in a bit upward pointing position. This position may not be entirely natural or comfortable, but it helps maintain the tension. This continuous nighttime tension strengthens plantar fascia, related musculature. It means that sudden morning stress on feet is no more painful.

Night splints keep feet pointing upward (dorsiflexed) at 5 to 15 degrees. To increase the effectiveness of such a treatment, foot specialist may add a pad below the toes. It would further increase nighttime tension on the plantar fascia.

The good thing about night splints is a benefit with minimal efforts. The strain caused by splints is mild. Thus a person gets used to it quickly, and will soon stop feeling any discomfort. Over the time it helps muscles and ligaments to become more resistant to strains.

Research shows that the biggest challenge in the implementation of such a therapy is adherence. Many people do not regularly use this splints, thus fail to get an adequate effect. It is imperative that a person living with plantar fasciitis must use splints daily. Using them irregularly may fail to provide any benefit.

Specialists strongly believe that treatment with the night splints must be started from the very first day of diagnosis. The first line of therapy should contain the use of NSAIDs along with night splints. When used together, these two modalities are enough to provide significant benefit within a month or two.

One comparative clinical trial showed that during the first month of use there was not much difference between those who used a splint and those who did not. However, from the second month onwards benefit was clearly and statistically evident.

Although most will benefit from the use of night splints within three months, however, it is vital to understand that there is no limit on how long night splints can be used. There is no known adverse effect on prolonged use. Thus for those who have a more severe form of plantar fasciitis, it is absolutely normal to keep wearing splints every night, till all gets well.

Finally, it must be understood that although they are called night splints, they can also be worn during the day. They can be worn just any time when you are not moving enough or having rest. So if you are on a long flight, wearing night splints will ensure that you will not feel any pain, as soon as you set your feet out of the plane.

References

1..http://www.shropshireccg.nhs.uk/media/1417/plantar-fascitis.pdf

2..https://www.cnwl.nhs.uk/wp-content/uploads/Plantar-Fasciitis-Information-Sheet.pdf

3..http://www.plantarfasciitis.com/blog/did-u-know-that-night-splints-also-may-be-worn-during-the-day-2519.html