Tendonitis in the hand, wrist and forearm occurs when tendons passing though these areas become inflamed. In severe cases of tendonitis the result can be painful and debilitating. Resting the wrist joint and splinting the hand and wrist generally are recognized as the most effective treatment when the condition is diagnosed and treated early.
Reasons for Splinting
Tendonitis is caused by inflammation of the tendon and its sheath. There can be a number of causes of tendonitis, and repetitive strain and hand overuse are primary reasons. Splinting is a means by which the wrist can rest and avoid further mechanical stress. Rest is an effective treatment for tendonitis.
Before considering a wrist splint for tendonitis, it is vital to confirm that tendonitis is the condition being treated. Other conditions such as carpal tunnel syndrome and arthritis can mimic the pain and swelling of tendonitis. However, splinting in these conditions is not necessarily the best treatment, and in some conditions one type of splint can be more effective than another. Additionally, night splinting may be sufficient for treatment in addition to limited daily splinting.
Tendonitis Wrist Splints
A splint for tendonitis is designed to keep the hand in the neutral position. There are a number of products commonly available which can do this, and most perform the same function. However, even with identical functionality there is a huge price range so you should compare costs and features. Your local pharmacist can help you, although the selections at Internet medical supply stores generally are greater and less expensive. Some splints immobilize the thumb but in most cases a thumb hole is sufficient to immobilize most of the thumb's movement. The most popular splints are made of flexible fabric containing a rigid internal support. Other splints are entirely composed of a hard plastic shell. The hard splints generally are more expensive and cumbersome than soft fabric splints, and they're more difficult to clean.
Night versus Day
Splinting at night is almost always a good strategy for resting the wrist. At night we bend and twist the hand unconsciously and this only aggravates tendonitis. Splint immobilization inhibits exaggerated and harmful movements. During the day, however, splinting actually can be more harmful if used continuously, especially while trying to work or use the affected hand. Unconscious hand movements during immobilization can make the wrist flex and extend isometrically, further adding to the damage. Also, some degree of joint movement is important to encourage blood flow and drain lymphatic fluid. Movement also minimizes the formation of adhesions around the tendon. Therefore, unless wrist hyperflexion and hyperextension must be restricted, splinting during the day should be used carefully and on a limited basis.
While it may be obvious how to use a wrist splint, some precautions must be taken. The splint should offer firm wrist support. That support should immobilize the hand and wrist, and should extend at least one-third onto the forearm. The splint should support the wrist in the neutral position, which is approximately in a straight line with the forearm. There should be a contoured rigid plate in the palm of the splint for added comfort. If the tendonitis is associated with deQuervain’s syndrome, it generally is necessary to use a splint with a thumb support to immobilize it. The more versatile splints are open down their length so the hand and arm can easily be slipped inside and secured, usually with Velcro straps. Glove-like splints generally do not offer adequate wrist support, and can be more painful to use if the tendonitis is severe. The splint should be comfortable. If it is painful or irritating then it should be adjusted, especially if it seems to constrict any blood flow.