Foot orthoses for the treatment of plantar fasciitis.
BACKGROUND
The literature suggests mechanical interventions such as foot orthoses and night splints are effective in reducing pain from plantar fasciitis. There is, however, a lack of controlled trials. We studied the effects of foot orthoses and night splints, alone or combined, in a prospective, randomized trial with 1-year followup.


METHODS
Forty-three patients (34 women and nine men with a mean age of 46 years) with plantar fasciitis were randomized to receive foot orthoses (n = 13), foot orthoses and night splints (n = 15), or night splints alone (n = 15). Data were available for 34 (79%) patients after treatment (12 weeks), and for 38 (88%) at 1-year followup. Pain, functional limitations, and quality of life were evaluated with the Foot and Ankle Outcome Score.


RESULTS
All groups improved significantly in all outcomes evaluated across all times (p < 0.04). At 12 weeks, pain reduction of 30% to 50% compared to baseline were seen (p < 0.03). At 52 weeks, pain reduction of 62% was seen in the two groups using foot orthoses compared to 48% in the night splint only group (p < 0.01). Better compliance and fewer side effects were reported for orthosis use. At 12 months, 19 of 23 patients reported still using foot orthoses compared to 1 of 28 still using the night splint.


CONCLUSIONS
Foot orthoses and anterior night splints were effective both short-term and long-term in treating pain from plantar fasciitis. Parallel improvements in function, foot-related quality of life, and a better compliance suggest that a foot orthosis is the best choice for initial treatment plantar fasciitis.
Roos
Ewa
E
Lund University, Department of Orthopaedics, Lund University Hospital, Lund, S-221 85, Sweden. Ewa.Roos@med.lu.se
Engström
Mikael
M
Söderberg
Bengt
B
D000328:Adult; D036981:Fasciitis, Plantar / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D010349:Patient Compliance; D011446:Prospective Studies; D011788:Quality of Life; D013165:Splints; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome