Night splints

What is a night splint, and how does it work?

A night splint (sometimes called a tension, posterior or dorsiflexion night splint) is a brace worn on your ankle and foot during sleep. It holds your ankle in a neutral position¹.

Think of it as a stretch you wear while you sleep. The aim is to stop your calf and your plantar fascia (the band of tissue under your foot) tightening overnight¹². Because of this, it's mostly aimed at pain with your first steps in the morning¹.

What is it used for, and how well does it work?

It's used mainly for plantar heel pain (plantar fasciitis) in adults, and the results are mixed. For people who haven't had treatment before, adding a night splint to usual care eased heel pain in the short term. It didn't significantly stop the pain coming back over two years³.

For long-standing pain (about 2 years on average), adding a splint to a home exercise programme gave little if any extra benefit. Both groups improved⁴. Most people were helped rather than cured⁴.

So expect gradual improvement rather than a quick fix. Pain with your first steps may not fully disappear, but it should ease gradually⁵. Being over 45 is linked with less improvement after 12 weeks⁶. For other problems, such as Achilles tendon pain, it isn't clear yet whether a splint helps.

Is a night splint right for me?

It's best supported for adults with plantar fasciitis, especially when the main problem is pain with the first steps in the morning¹. Pain that's much worse when you first start walking after sleeping or resting, and eases as you move, fits this pattern⁷.

Get your heel pain examined before you use a splint. Other causes of heel pain should be ruled out first. These include nerve irritation, Achilles tendon problems, a stress fracture of the heel bone, thinning of the heel's fat pad, or a lump in the sole⁸².

The trials were in adults⁹, so children with heel pain need assessment by a health professional.

What happens when I use a night splint?

Most people start with the basics: education, plantar fascia stretching and, where suitable, taping¹⁰. A night splint is usually considered when education, stretching and options such as taping, insoles or shockwave therapy haven't helped enough⁸.

The splints used in studies were custom-made¹¹. Ask your podiatrist or physiotherapist about fitting and how long to try one, because there's no standard schedule.

Ideally a splint is worn all night, but that's often impractical. Wearing it for 15–30 minutes at a time, several times a day, should have a similar effect⁵. Putting it on about 10 minutes before you get out of bed can help with first-step pain⁵.

What are the risks and side effects?

The main problem is comfort. Splints can be uncomfortable and disturb sleep, and many people stop wearing them¹. Some people report sleep problems with these devices⁴.

If your splint is uncomfortable, tell your podiatrist or physiotherapist rather than just stopping. They can review the fit, the wearing time or the choice of treatment. Also tell them about any new tingling or loss of feeling in your foot.

What else can I try?

Core care comes first: taping, plantar fascia stretching and individualised education, used together. Taping and stretching both ease first-step pain in the short term¹⁰. If these haven't been enough after about 4–6 weeks, a podiatrist can discuss extras such as shockwave therapy or orthoses (shoe inserts)¹⁰.

Pain fell more with foot orthoses than with a night splint alone, and people were far more likely to keep using orthoses¹². A night splint is better seen as an add-on than a first step.