Is it advisable for a patient with foot pain to continue using Rosendahl shoes (orthotic shoes) for work despite improvement in knee pain, and should they continue using a night splint?

Management of Foot Pain with Orthotic Shoes and Night Splint

For patients with foot pain, orthotic shoes like Rosendahl shoes should be continued if they provide symptomatic relief for knee pain, and night splints should be maintained as they are helping with foot symptoms.

Orthotic Shoe Use

• Orthotic shoes (such as Rosendahl shoes) are conditionally recommended for patients with foot pain, especially when they provide relief for associated knee pain 1, 2
• Modifications to footwear can redistribute pressure and reduce pain in patients with foot conditions, particularly in those with structural foot issues 2
• The American Academy of Family Physicians recommends appropriate orthotic modifications to reduce pain and improve function in patients with foot pain 2

Benefits of Continuing Orthotic Shoes

• Orthotic shoes can help redistribute plantar pressure from ground reactive forces, which is particularly important for patients experiencing foot and knee pain 1
• For patients with foot and/or ankle involvement, the use of bracing, orthoses, and/or taping is conditionally recommended over no bracing, orthoses, and/or compression 1
• Continued use of orthotic shoes that provide knee pain relief suggests they are effectively modifying biomechanics in a beneficial way 1, 2

Night Splint Effectiveness

• Night splints are beneficial for various foot conditions and should be continued if the patient reports improvement 3
• Studies have shown that night splints can effectively treat recalcitrant plantar fasciitis, with 88% of patients showing improvement after using night splints for one month 3
• Night splints work by maintaining the foot in a specific position during sleep, which can help reduce morning pain and stiffness 3, 2

Comprehensive Approach to Foot Pain Management

• A personalized management plan should include both appropriate footwear and night splinting when beneficial, as part of a stepped-care approach 1
• For patients with foot pain, orthotic interventions should be combined with other modalities such as activity modification and exercises 1, 2
• If a patient reports improvement with night splints, this suggests they are addressing an underlying mechanical issue that benefits from maintained positioning during rest 3, 2

Monitoring and Follow-up

• Regular assessment of symptom improvement with continued use of orthotic shoes and night splints is recommended 2
• If symptoms worsen despite orthotic use, referral to a specialist (podiatrist, orthopedist, or rheumatologist) may be necessary 1, 2
• Adjustments to orthotics may be needed over time to accommodate changes in foot structure or symptoms 2

Common Pitfalls to Avoid

• Discontinuing effective interventions (like orthotic shoes or night splints) prematurely when they are providing symptomatic relief 2
• Failing to recognize the interconnected nature of foot and knee pain, where interventions benefiting one area may positively impact the other 1, 2
• Inadequate footwear modification or improper use of night splints can perpetuate symptoms rather than alleviate them 2