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Plantar fasciopathy treated with dynamic splinting: a randomized controlled trial
Larry Sheridan1, Angel Lopez, Andres Perez
1Musculoskeletal Services, Kaiser Permanente, Sacramento, CA, USA.
Background:
Plantar fasciopathy (or plantar fasciitis) is considered to be one of the most common foot abnormalities, affecting up to 2 million Americans each year, and the chief complaint is acute heel pain. Therapeutic protocols for this condition have included stretching exercises, corticosteroid injections, physical therapy, and foot orthoses, but a single modality has not been found to be universally effective. We sought to determine the efficacy of stretching with dynamic splinting for the treatment of plantar fasciitis.
Methods:
Sixty patients (76 feet) were enrolled in this 12-week study from four different clinics across the United States. Patients were randomly categorized into experimental and control groups. All of the patients received nonsteroidal anti-inflammatory drugs, orthoses, and corticosteroid injections if needed. Thirty experimental patients also received dynamic splinting for nightly wear to obtain a low-load, prolonged-duration stretch with dynamic tension. The dependent variable was change from baseline in Plantar Fasciopathy Pain/Disability Scale score, and the independent variable was group (experimental versus control).
Results:
Two-sample t tests were calculated, and there was a significant difference in the mean change scores of experimental versus control patients (-33 versus -2 points, P < .0001).
Conclusions:
Dynamic splinting was effective for reducing the pain of plantar fasciopathy, and this modality should be included in the standard of care for treating plantar fasciopathy.