Night Splint

Night Splint

Plantar Fasciitis: an Affliction on the Foot

Plantar Fasciitis is a rather seemingly common condition of the foot causing significant heel pain and proximal foot arch pain. The most common presentation of plantar fasciitis is pain with the first step in the morning. The worst pain is with the first step in the morning. Typically people feel like they are walking on glass in the first few steps as they experience tremendous pain and a proximal aspect of their foot where the plantar fascia inserts into the heel bone. The plantar fascia acts as an anchor for the foot arch. As such it is susceptible to significant strain over the course of a day. This particularly happens when people are wearing shoes without proper support.

People will commonly present to the doctor after the symptoms have been present for over 3 months. Frequently, the doctor will recommend some stretching and some ice and some non-steroidal anti-inflamatories. Frankly, these regimens have not been shown to be particularly useful in studies. Certainly for a few people with minor disease, perhaps it will help; particularly the icing aspect. Certainly it is a good idea to keep muscles stretched and while these stretching exercises may be a good idea for someone overall health, again not particularly helpful as far as treating the problem at hand. Anti-inflammatory medications have never really been shown to help for this particular problem.

Effective treatment for this would involve arch support through the day and this can take the form of over the counter arch supports. Certainly there are numerous reasonable arch supports on the market. Dr. Scholl’s has a good product – heel pain relief orthodics that are reasonable. There are a few others that are available, and certainly if you go to your local drug store, you’ll find some non-Dr. Scholl’s products as well. Most of the good products will run about 2/3 the length of the foot. They’ll have a degree of firmness to them, and they will have some obvious arch support. Certainly, this will likely be helpful and is a good initial approach to plantar Fasciitis therapy.

For people who are really in a bad way, the night splints can be effective. One thing to understand about plantar fasciitis pain is it becomes a recurrent problem and really becomes a little bit of a vicious cycle. The cycle occurs during the day. Someone will cause wear and tear on their plantar fascia at the insertion on the heal bone, and at night people’s feet go limp. Their foot and leg are certainly not in the L position that they are through much of the day. This causes the plantar fascia to become relaxed similar to a relaxed rubber band. The reason the first step hurts so much is all that healing that’s been going on over night to try to rebuild bridges where there has been micro tears, are all ripped out with those first few steps as the rubber band that was “healed” in a lax position becomes stretched. Therefore sleep becomes non-restorative in regards to healing the heel pain. The night splint addressed that by basically keeping the foot in an L shape over the course of the evening. There are numerous pictures of this on the internet. Frankly there are products over the internet that would address this. They can be given through a doctor’s office with a prescription and there’s quite a markup on these non-custom fitted braces when they are obtained in the traditional way through medical insurance, etc.

In summary, when your heel starts hurting and it hurts with the first step in the morning, immediately start icing at night and get yourself an over the counter foot orthodic. It provides significant arch support described above. If this doesn’t work, then I would consider talking to your doctor and possibly adding the night splint. If these fall short, then you may need a steroid injection to sort of get you over the hump and start this healing process.