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Dynamic Solution to Heel Pain

Heel pain is a common foot problem in the United States. There are many possible causes of heel pain. Plantar fasciitis is one. The plantar fascia is a thick band of tissue under the foot. It starts on the bottom of the heel bone and goes to the base of each toe.

Getting up in the morning is the hardest thing for a patient with plantar fasciitis. That first contact with the floor is often very painful. The pain usually subsides after getting up and moving around. It may come back later in the day after any period of rest or inactivity.

Many patients get help for this problem with shoe inserts, anti-inflammatory drugs, stretching, massage, and taping the foot. When these treatments don't work, a special splint can be worn at night. The splint holds the ankle in a position called dorsiflexion. In this position, the foot is angled upward toward the face.

Splinting for plantar fasciitis was first used in the early 1990s. Since that time, studies have been done to show how well it works. Researchers report success, but getting patients to wear the device every night is sometimes a problem. Scientists are trying to improve the design of the splint to make it more comfortable. They believe that a better splint will give even better results.

A new splint that allows for slight movement has been studied. It is called a dynamic splint. It holds the foot in dorsiflexion, allows the foot to move out of that position, and then returns the foot to dorsiflexion. A spring-loaded ankle hinge makes this possible.

Night splints are an effective tool in the treatment of plantar fasciitis. A new, more comfortable splint is on the market. Increased comfort means the patient will probably wear it more often and get better results. Pain relief was reported by 75 percent of the patients after only one month. This improvement was still present six months later.

References: Gregory C. Berlet, MD, FRCS(C), et al. A Prospective Trial of Night Splinting in the Treatment of Recalcitrant Plantar Fasciitis: The Ankle Dorsiflexion Dynasplint. In Orthopedics. November 2002. Vol. 25. No. 11. Pp. 1273-1275.

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