Part of Plantar fasciitis
Night splints for plantar fasciitis: do they help?
Warning signs, and when to get help
Do night splints help plantar fasciitis?
A night splint for plantar fasciitis is one of the few things in this field where the guideline is more enthusiastic than the trials, which is the reverse of what people expect. The US physical therapy guideline recommends a 1 to 3 month program of night splints, on strong evidence, for people who consistently have pain with the first step in the morning (Koc and colleagues, 2023). Two randomized trials have added one to a program and found no measurable benefit from it.
Both things are true at once, and the way to use that is to decide what you are hoping for. If you are being offered a splint by a clinician because your mornings are the worst part, that is a defensible choice backed by a guideline, and the NHS lists night splints among the things a podiatrist may recommend. If you are about to buy one yourself in the hope it is the missing piece, the trials are the better guide and they say it is not.
One detail about the device before the evidence. It is worn in bed. It is not a walking boot: those are rigid, they are prescribed to take load off something that is healing, and nothing here is advice to immobilize a sore foot.
What does a night splint actually do?
It stops the ankle pointing down while you sleep, which is how the US physical therapy guideline defines the device, and some designs draw the toes up as well. The band under your foot and the calf then spend the night at length instead of settling short. The idea follows from how this condition behaves: your heel is at its worst on the first few steps after hours of rest, the pattern described in heel pain in the morning.
Treat the mechanism as the reasoning behind the device, not as something a trial has demonstrated. What was measured in the trials was pain and function, not the tissue, and the measurements did not favor the splint.
There are two broad shapes on the market. A boot-style splint holds the whole ankle fairly rigidly, and a soft, sock-like version applies a gentler pull toward the shin. The one comparison with any evidence behind it is not that one: a single study set an anterior splint, with the shell down the front of the shin, against a posterior one behind the calf, and the people in the anterior splint were more satisfied with it. A systematic review that collected that study rates the evidence weak, because it is one study (Schuitema and colleagues, 2020).
So if you are being fitted for one and find a boot unbearable, a lower-profile front-of-shin design is a reasonable thing to ask about. Nothing on this page names a brand or a model, because no study supports choosing one.
What the guideline and the trials each found
Start with the guideline, because its grade is the strongest claim in the field. The 2023 revision carries the night splint recommendation forward from the 2014 version unchanged, and the reason it gives for leaving it alone is one sentence: "No studies investigated the effectiveness of night splints." A strong recommendation that the revision did not revisit is not the same thing as a strong recommendation built on new evidence, and anyone weighing a splint deserves to know which they are looking at. So the grade rests on what was available before 2014, and the trials set out below are not what produced it.
Now the trials, in date order. Probe and colleagues randomized 116 patients with plantar fasciitis. Everyone got an oral anti-inflammatory, Achilles stretching and shoe recommendations for a month; one group also wore a dorsiflexion night splint for three months. Patients were reviewed blind at 4, 6 and 12 weeks, with a final follow-up at an average of 19 months.
Overall, 68 percent reported improvement on that non-operative protocol over the 12 weeks, and no statistical difference was seen with the presence or absence of a night splint. Age over 45 was a significant predictor of poor improvement at 12 weeks (Probe and colleagues, 1999).
Wheeler took the same question to a modern rehabilitation program. He randomized 40 people with long-standing plantar fasciitis to a structured home exercise program, with or without a tension night splint. Both groups improved, and at 3 months there was no significant difference between them in pain, function or flexibility, though the author allows a possible earlier benefit in the splint group and calls that data unclear (Wheeler, 2017).
Those two are the trials that asked our question: does a splint add anything to a program? Widen the lens and the picture looks split instead of negative. A systematic review of mechanical treatments collected 10 articles on splints worn at night. In the five that compared people with and without one, four measured pain and two of those four found significantly lower pain scores with the splint, while function improved in one of the two studies that measured it.
The same review found something the trials above did not test: pairing a night splint with an insole improved pain and function more than either the splint or the insole alone, though one study in the set reported the opposite (Schuitema and colleagues, 2020). It is a weaker body of evidence than the guideline's grade suggests and a more interesting one than two null trials suggest.
And then the absence that is worth as much as any of it. The best practice guide for plantar heel pain, built from a systematic review of 51 trials in 4,351 people plus expert interviews and a patient survey, found one night splint trial among those 51 and then set out a full plan of care without a splint in it anywhere (Morrissey and colleagues, 2021).
Which type, and how do you use one?
The usable answer is short because the sourced detail is thin. The program length with evidence attached is 1 to 3 months (Koc and colleagues, 2023), and that is also the period both trials used.
For hours per night and for the exact angle at the ankle, no source we can cite gives a figure, and we are not going to invent one for you. If a physio, physical therapist or podiatrist has fitted yours and written you a plan, their plan is the one to follow, because they have seen your foot. If you have bought one and are using it anyway, short spells early in the night, building up, is the sensible way in.
Two checks matter every night, and they are the reason this section exists at all. Look at the skin when it comes off in the morning, and pay attention to your toes. If it leaves a mark on your skin, or your toes look swollen or feel more numb with it on than without it, loosen the straps, and if that does not settle within a few minutes, take it off for the rest of the night and get the fit checked before you wear it again. If your toes tingle, go numb or turn cold, pale or blue while you have it on, take it off at once. If feeling and color do not come back quickly, call emergency services or go to an emergency department straight away, and do not drive yourself.
If you have diabetes or reduced feeling in your feet, a splint is something to set up with your podiatrist or foot team rather than to try on your own, and the skin of both feet gets checked every day. A device pressing on a foot that cannot feel it is how a pressure mark becomes an ulcer.
What if you cannot sleep in one?
Then take it off, and do not feel you have failed. They are bulky, they stop the ankle moving, and a good number of people cannot settle in one at all.
The evidence makes that an easy decision. If a splint had been shown to add something a program could not, persevering through broken nights might be worth arguing about. The two trials that tested exactly that found it did not, and nothing in the wider evidence is strong enough to buy a month of bad nights with, so sleep is the thing to protect when you are dealing with persistent pain.
A middle path, if you want to give it a fair run: wear it for the first hour or two in bed and take it off when you wake, instead of committing to a whole night from the start. If it still wrecks your sleep, stop.
What else helps the first steps out of bed
This is where your effort is better spent, and all three of these have more behind them than the splint does.
Stretch before you stand up. The Australian HANDI entry names the two moments that matter, before the first step of the morning and before standing after a long sit, and asks for 10 repetitions at least 3 times a day for at least 8 weeks. The plantar fascia stretch is the one to do sitting on the edge of the bed, with the calf stretch alongside it, and a few ankle pumps first to get the joint moving. The morning routine sets it out in order, with the technique errors that waste it.
Put something supportive on your feet before the first step. A pair kept by the bed means your stretched arch lands on cushioning and not on cold tile, and shoes for plantar fasciitis covers what to look for in an indoor pair.
Then do the part that actually changes the heel, which is the loading work in the staged program. The same guideline that recommends the splint recommends stretching and manual therapy on strong evidence and exercise including resistance training for the foot and ankle muscles on moderate evidence (Koc and colleagues, 2023). For the short-term measures, taping and insoles sets out what each of those does.
How long to give it before you decide
One to three months is the program length with a source behind it, so if you are going to try a splint, give it the full run and not a fortnight. Morning pain moves slowly, and it is usually the last symptom to go, which how long plantar fasciitis lasts goes through.
Judge it on the first few steps of the day, over weeks, and not on how the night felt. And judge it alongside everything else you are doing, not in isolation, because the trials above are a reminder that most of the improvement in both of their splint groups came from the program.
If your mornings are no better after the full one to three months, that is your answer, and nothing is lost by stopping. If they are better, it is reasonable to keep going while you build the loading work up, and then to come off it and see whether anything changes.
Is this the same question for Achilles pain?
No, and the answer comes out differently, which matters if you have read about splints for the tendon at the back of the heel. That question has its own trials, and they tested a splint against and alongside an eccentric calf program rather than a plantar fascia program. Night splints and morning Achilles pain sets out what those found.
The practical point is that the two conditions sit in different places in the foot, and a device recommended for one is not automatically right for the other. If you are not certain which of them you have, that is a reason to be assessed rather than to buy a splint and find out.
When to see a physio or doctor
See someone if the pain is severe or stopping you doing normal activities, if it is getting worse or keeps coming back, or if 2 weeks of self-care has not helped, which is the NHS threshold. A splint is also one of the few things here where a fitting matters, so if you are going to use one, having a physio or podiatrist check how it sits is worth an appointment on its own.
Some things on this page need more urgency than an appointment. Pain that is there at night and at rest as well as on your feet, and that is getting worse, has its own lines and its own timings in the warning list below, and the fact that you are reading a page about sleeping in a splint is a reason to read them, not to skip them. Numbness or tingling in the foot needs checking, and anything that changes the color or temperature of part of the foot is an emergency. New foot pain with diabetes needs seeing, which the NHS gives as its own reason to see a GP.
This page is education rather than advice about your own foot, and it recommends no product. A physio, physical therapist or podiatrist who can examine your heel is the person to tell you whether a splint has anything to offer you.
Related exercise programs
Warning signs
Get emergency help now
- Part of your foot or a toe turns cold, pale, blue or black. Call emergency services or go to an emergency department straight away, and do not drive yourself, as the blood supply to the foot may be blocked.
Get help today
- Same day: you have diabetes or numb feet and find a new blister, cut or sore on your foot, especially one you did not feel, a wound that smells or is leaking, or new pain in your foot that you cannot explain. Get it seen by your doctor or foot team the same day. If you also have a fever or feel very unwell, redness is spreading up your foot or leg, or part of your foot or a toe turns black, go to an emergency department.
- Same day: you have diabetes or numb feet, and one foot becomes hot, swollen or red, or changes color or shape, with or without pain. Take your weight off that foot straight away and get advice the same day from your doctor or your diabetes foot team. This can be Charcot foot, where the bones and joints of the foot are damaged and the foot can collapse. Do not exercise that foot until it has been checked. If you also have a fever or feel very unwell, or redness is spreading up your foot or leg, go to an emergency department.
- The heel or foot is hot, red and swollen, or you have a fever or feel unwell. Get medical help the same day, and go to an emergency department if you feel very unwell. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
- The pain is there at night or at rest as well as when you stand and walk, and it is getting worse. If you are being treated for cancer now, contact your cancer team the same day.
Book an appointment
- You have numbness, tingling, burning or loss of feeling in the foot. Book an assessment with a doctor or physio in the next week or two. If it came on over hours or days, started after an injury, is spreading, or comes with weakness in the foot, get medical advice the same day.
- The pain is there at night or at rest as well as when you stand and walk, and it is getting worse. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse.
- The pain is there at night or at rest as well as when you stand and walk, and it is getting worse. See your doctor within a few days.
- Both heels hurt and you also have swelling or morning stiffness in other joints or your lower back. This is not an emergency, but see your doctor in the next week or two, as it can be a sign of an inflammatory arthritis.
Common questions
Do night splints work for plantar fasciitis?
The guideline says yes, the two trials that added one to an exercise program found it added nothing, and the wider trial evidence is split, so the fair answer sits between them. The US physical therapy guideline recommends a 1 to 3 month program of night splints on strong evidence for people who consistently have first-step morning pain (Koc and colleagues, 2023). Against that, Wheeler (2017) added a tension night splint to a structured home exercise program in 40 people and found no significant difference in pain, function or flexibility at 3 months, and Probe and colleagues (1999) randomized 116 patients to a non-operative protocol with or without a dorsiflexion splint for 3 months and found no statistical difference either way. If a clinician has given you one with a plan, it is not a strange choice. If you are deciding alone, the stretches and the shoes are where your effort pays better.
How long should I wear a night splint each night, and for how many weeks?
The only program length with a source behind it is the guideline's 1 to 3 months (Koc and colleagues, 2023), and the trials used 3 months as well. For hours per night, no source we can cite gives a figure, so we are not going to invent one. If a physio, physical therapist or podiatrist has fitted yours and given you a plan, follow theirs. If you bought one yourself and are using it anyway, short spells at first, not a full night, is the sensible way in, and give it the weeks instead of judging it after two nights, because first-step pain shifts slowly. Your physio will adjust this.
Why can I not sleep in my night splint?
Because they are bulky, they stop the ankle moving, and plenty of people simply cannot settle in one. That is a common experience, not a failure of effort, and it matters more than it sounds: the trials found a splint added nothing measurable to a program, so trading a night's sleep for it is a bad bargain. Sleep is worth protecting in its own right when you are dealing with pain. Try it for short spells early in the night if you want to give it a fair run, and let it go if that does not work.
Do night splints cure plantar fasciitis?
No, and nothing on this page should be read that way. A splint holds the foot in a position overnight. It does not build any tolerance into the heel, which is what the loading work does, and both trials above tested it as an addition to a program rather than as a treatment on its own. The guideline that recommends it also recommends stretching and manual therapy on strong evidence and resistance training for the foot and ankle muscles on moderate evidence (Koc and colleagues, 2023). The splint is a comfort measure for the mornings at best.
Can I make my own night splint?
There is nothing published on a homemade one that we could cite, and the devices in both trials were manufactured splints, so anything we said about a strapped-up version would be invention. What we can say is where the hazards are. A device you have improvised is the one most likely to press in the wrong place or to tighten, and a foot cannot tell you it is in trouble for the seven hours you are asleep. If it leaves a mark on your skin, or your toes look swollen or feel more numb with it on than without it, loosen the straps, and if that does not settle within a few minutes, take it off for the rest of the night and get the fit checked before you wear it again. If you have diabetes or reduced feeling in your feet, do not improvise anything: ask your foot team.
References
- Koc TA Jr, Bise CG, Neville C, et al. Heel Pain - Plantar Fasciitis: Revision 2023. Journal of Orthopaedic and Sports Physical Therapy. 2023;53(12):CPG1-CPG39. https://doi.org/10.2519/jospt.2023.0303
- Wheeler PC. The addition of a tension night splint to a structured home rehabilitation programme in patients with chronic plantar fasciitis does not lead to significant additional benefits in either pain, function or flexibility: a single-blinded randomised controlled trial. BMJ Open Sport and Exercise Medicine. 2017;3(1):e000234. https://doi.org/10.1136/bmjsem-2017-000234
- Probe RA, Baca M, Adams R, Preece C. Night splint treatment for plantar fasciitis. A prospective randomized study. Clinical Orthopaedics and Related Research. 1999;(368):190-195. https://doi.org/10.1097/00003086-199911000-00023
- Morrissey D, Cotchett M, Said J'Bari A, et al. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. British Journal of Sports Medicine. 2021;55(19):1106-1118. https://doi.org/10.1136/bjsports-2019-101970
- Schuitema D, Greve C, Postema K, Dekker R, Hijmans JM. Effectiveness of Mechanical Treatment for Plantar Fasciitis: A Systematic Review. Journal of Sport Rehabilitation. 2020;29(5):657-674. https://doi.org/10.1123/jsr.2019-0036
- Royal Australian College of General Practitioners. Stretching exercises for plantar fasciitis. Handbook of Non-Drug Interventions (HANDI), first published October 2014. https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/a-z/s/stretching-exercises-for-plantar-fasciitis
- NHS. Plantar fasciitis. Page last reviewed 14 February 2025. https://www.nhs.uk/conditions/plantar-fasciitis/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-24.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.