Splints

Hand and wrist splints are designed to protect and support painful, swollen or weak joints and their surrounding structures by making sure your hand and wrist are positioned correctly. Splints can be used for joints affected by arthritis or for other conditions, such as carpal tunnel syndrome.

There are two main types of splint:

• splints used while resting the joints of the hand and wrist
• splints used to support the hand and wrist while working.

Whichever type of splint you use, it's best not to wear it all the time as this can increase stiffness in your joints.

A resting splint supports your hand and wrist in the best position while you're resting. It can help reduce swelling and pain.

Resting splints are usually made from a moulded thermoplastic and are fitted with Velcro fastening straps and are usually made specially made for you by a physiotherapist, occupational therapist or orthotist.

Resting splints are best used:

• if you have pain overnight that disturbs your sleep
• occasionally during the day if your hands are especially painful
• during flare-ups of your arthritis.

Some people find that compression (Isotoner) gloves are also helpful in reducing pain and swelling and are easier to wear. 

How do I put it on?

1. Undo the straps.
2. Place your hand into the splint so that it’s in contact with the palm of your hand and there’s no space between your wrist and the splint.
3. If there’s a thumb section make sure that your thumb is also in contact with the material.
4. Do up the straps – not too tight – starting with the strap nearest your elbow.

You may find it helpful to leave the strap over the fingers done up so that you can slide your hand in or out. This means there’s one less strap to undo.

Caring for your resting splint

Clean your resting splint by wiping it with a damp cloth. You may use warm, soapy water or a mild detergent. Use a towel to dry it and don’t store it on a sunny window sill or near a radiator.

Working splints provide flexible support for your wrist and hand joints while you’re doing tasks that you might otherwise find painful.

They can help increase your grip strength, reduce pain and make jobs easier to manage.

Working splints are best used when:

• your wrist or thumb is swollen
• you're having more discomfort than usual
• the joints in your hand feel weak. 

Working splints are usually made of an elastic or light synthetic rubber-type fabric (e.g. neoprene) with Velcro straps. They’re available commercially or from physiotherapy or occupational therapy departments.

If you want to wear any type of working splint while driving, contact your insurance company first for advice about whether your cover will be affected.

There are different types of working splints, described below:

Wrist working splint

This is a wrap-around splint that has a metal bar inserted in a pocket on the palm side of your wrist. This helps to stabilise your wrist joint in a comfortable and efficient position.

How do I put it on?

1. Undo the straps.
2. Place your hand into the splint so that the supporting metal bar is fitting closely into your palm.
3. Roughly line up the edges.
4. Do up the straps – not too tight – this time starting with the strap nearest your wrist, as this is the narrowest part (if you start with the strap nearest your elbow it tends to push the splint down and restrict movement at your fingers. This isn’t the case for resting splints, which you fasten from your elbow first).

Wrist wrap working splint

This is a wrap-around splint that gives light support to your wrist.

How do I put it on?

1. Place the loop over your thumb.
2. Take the long section of the support round the back of your wrist and wrap around, pulling slightly.
3. Do up the strap.

Thumb spica working splint

This is a wrap-around splint that goes around your thumb and wrist. Some have an extra support for the thumb joints. This helps to stabilise the thumb.

How do I put it on?

1. Undo the straps.
2. Place the reinforced strip on top of your thumb joints.
3. Do up the straps – not too tight.

Caring for your working splint

It's a good idea to wear cotton or rubber gloves over your splint, for example when gardening or cleaning, to help prevent it from getting dirty or wet.

If the splint contains a metal bar you should remove it (if possible) before the splint is washed. Check the position of the bar and be careful to replace it in the same position after washing the splint.

Working splints can be hand-washed in warm soapy water and then air-dried. Some splints can be washed in a washing machine, but you should check the label. It’s a good idea to place the splint in a pillowcase first to prevent the Velcro attaching to other washing.

It's best not to wear your splint all the time, otherwise your joints may become stiff. And you shouldn't wear a working splint overnight unless you’ve been advised to by your therapist or nurse.

When you take the splint off, make sure that you do some gentle wrist, finger and thumb exercises to help stop your joints from stiffening up.

Stop wearing your splint if it:

• rubs or causes pain
• doesn’t fit any more or is worn out
• leaves red marks or makes your fingers tingle.

If your skin is sore when you wear your splint then contact your rheumatology department or the therapist that issued the splint. It may be that you’re allergic to the material of the splint, or that it’s rubbing and causing too much pressure on your skin.

Some types of splints are available from pharmacies, sports shops and online retailers.

However, before you buy one, it’s a good idea to get advice from a healthcare professional (such as an occupational therapist, physiotherapist or hand therapist). Any member of the healthcare team, including your doctor or rheumatology nurse can refer you to these services. 

Your therapist may be able to provide a splint or arrange for an orthotist to make one designed for your specific needs.

You shouldn’t borrow or use other people’s splints, or let them use yours, as they may not be suitable.