[The effectiveness of dorsiflexion night splint added to conservative treatment for plantar fasciitis].

OBJECTIVES

We evaluated the effectiveness and results of night splint applications for the treatment of plantar fasciitis.

METHODS

The study included 44 patients (53 feet) with plantar fasciitis. The mean symptom duration was 7.2+/-5.9 weeks (range 1 to 24 weeks). Calcaneal spurs were detected in 12 feet. All the patients received classic conservative treatment and all were recommended to use a night splint that kept the ankle in 5-degree of dorsiflexion for eight weeks. Twenty-five patients (14 females, 11 males; 31 feet) did not accept to use a night splint, whereas 19 patients (12 females, 7 males; 22 feet) did. Evaluations were made with the AOFAS ankle-hindfoot rating scale and a visual analog scale (VAS) before and after two months of treatment. The mean follow-up periods were 33.8 months (range 12 to 54 months) and 32.7 months (range 13 to 53 months) for those who completed treatment with and without the use of a night splint, respectively.

RESULTS

Although there were no significant differences between the two groups with regard to the initial AOFAS and VAS scores, patients using a night splint exhibited significantly higher improvements in both scores at the end of the second month (p=0.01 and p=0.001, respectively). Heel pain recurred in three feet (13.6%) and in nine feet (29%) with and without night splint applications, respectively. Overall, the presence of a calcaneal spur, bilateral involvement, and body mass index were not correlated with patient satisfaction and recurrences. There was no correlation between the presence of a calcaneal spur and body mass index. However, symptom duration till treatment showed a significant correlation with recurrences (r=0.326, p=0.031).

CONCLUSION

Patients without previous treatments for plantar fasciitis obtain significant relief of heel pain in the short term with the use of a night splint incorporated into conservative methods; however, this application does not have a significant effect on prevention of recurrences after a two-year follow-up.