For the purposes of this discussion, a “splint” also includes a “brace”. By definition, a splint is used to immobilize a joint while a brace is used to support or align a body part in the correct position. Thus, both are appropriate terms here.
When it comes to carpal tunnel syndrome, tendonitis, repetitive strain injury and most other dysfunctions of the hand or wrist, conservative therapy usually provides the highest rate of recovery. When you combine soft-tissue therapy with stretching, exercise and massage, the results can be remarkably rapid and yield long-term benefits.
In general, almost every dysfunction of the wrist and hand will require you to first rest the joint. Rest is one of the body’s first defenses against injury and disease. Your body forces you to become immobile so its healing mechanisms can work unimpeded. When you’re sick, in pain or injured you often feel tired and worn out because your body is forcing itself to shut down to begin the healing process.
But even with generous rest, at times it also is necessary to move the body (or joint or limb) a little bit for a number of good physiological reasons. Total immobilization is not only unhealthy but also dangerous. But this doesn’t mean you should move your joints around in a stressful manner – just moving them a little bit can be enough. Moving is important to facilitate blood flow, lymphatic drainage and minimize the potential of adhesions within the tissues.
So if you’re going to use a splint you must consider immobilizing the joint temporarily by allowing it to move occasionally when the split is removed.
Pros and Cons of Splinting
Some pathologies of the hand and wrist, like carpal tunnel syndrome, cannot be cured – not with splinting, surgery or any other magic bullet. You can only treat the symptoms and manage the disease – just like managing (but not curing) diabetes with diet or insulin.
Splinting simply allows the hand to rest and recover. Period. It keeps the joint in its neutral position. This means that the joint is in a position that produces minimal stress to the tissues inside.
At night, during sleep, if you have any hand or wrist dysfunction, you should always wear a splint. When we sleep we tend to twist and bend our hands unconsciously. This can produce tremendous stressful forces on the wrist joint which is already trying to heal itself. So any healing progress you make while awake can be reversed at night if you don’t take precautions. Also, when we sleep we tend to make a fist and this also produces unwanted stresses inside the wrist and hand. Most people find that night splinting is uncomfortable at first. But like anything else you wear, the initial discomfort quickly vanishes and you won’t even know you’re wearing one.
Nobody is sure is full-time is better than night splinting. However, consider that during the day it’s almost impossible for anybody to not move the hand or wrist. If you’re wearing a splint, an unconscious flinch or twitch against an immobile support can actually cause harm. It’s basically an isometric maneuver; if there is no “give” in the splint, then your tissues are working harder against the solid force – and that’s where even more damage will probably occur.
Therefore, it’s recommended you wear a splint during the day only on a limited basis, if at all. You should, however, rest and limit your hand movements as much as you can. In addition, you should perform mild stretching exercises of the hand and wrist. These are very specific and can be found at any number of internet resources.
Finally, you should include self-massage in your daily regimen. Massaging the wrist and forearm is beneficial for most dysfunctions of these tissues. In combination with the splinting and stretching exercises, self-massage is your best first-line therapy. Specific self-massage techniques also can be found at a number of internet resources.
Types of Splints and How to Use Them
Incredibly, most splints do exactly the same thing – yet there’s an astounding range of prices. A $20 product often does precisely what a $100 product does. So you should shop around.
Your local pharmacy, medical supply store and on line retailer are the most common places to find them. The selection is larger on line.
There are a huge variety of splints available. If you have a specific dysfunction, like carpal tunnel syndrome, then choose a product that is designed specifically for that purpose. That’s because such “specific” splints accommodate special problems of the dysfunction, like ease of slipping it on and off, insuring your wrist is in the neutral position, etc.
Rigid plastic splints (like “casts”) are more cumbersome than soft ones. They also are more difficult to clean. Rigid splints also are more difficult to adjust than soft splints.
With soft splints, choose one that is sturdy and keeps your wrist level with your forearm. It should have a metal plate curved like the palm of your hand inside the palm-side fabric. This plate should be removable so you can wash the product.
You may or may not want to choose a product that immobilizes your thumb. This depends on your condition. If you have carpal tunnel syndrome, for example, you want your thumb to be free, whereas with de Quervain’s syndrome, you will want to immobilize it.
Also, choose a splint that opens down its length and has Velcro straps. Some splints are designed like gloves, where you must slip your hand through the product. If you have hand pain, that can be difficult. The open-type product can be easily applied, and the Velcro straps will allow you to tighten it.
Do not substitute a glove for a splint. Gloves provide some support and are sold in pharmacies as well. However, they do not provide the proper support that you need.
When you wear the splint, make sure it’s tight but not constricting. Remember, you want to immobilize your wrist joint. You do not want to impede blood flow or cause skin irritation.
If you feel pain while wearing the product, then something’s wrong. Re-adjust it so it’s comfortable and not painful, and make sure you have the proper size for your hand.
You should wear a splint only as a means to rest your wrist joint. For a large majority of conditions, simple rest is enough to manage the dysfunction to the point where the tissues heal and the discomfort is gone forever. And if you are aware of how you damaged your tissues to begin with (like overdoing tennis lessons) you can take steps to be more vigilant the next time.
With rest, splinting, stretching exercises and self-massage, most hand and wrist dysfunctions will resolve in a couple weeks to months.
Only you can determine whether splinting is right for your condition. Like most medical treatments, splinting is generally well-suited for a majority of aliments. And it usually works very well, especially in conjunction with other therapies. But these products must be used properly and only when appropriate.