Rose Mary has been an occupational therapist since 1987. She has extensive experience treating conditions of the hands and arms.
The Universal Benefits of Resting Hand Splints
I have found, overwhelmingly, that clients with arthritis experience relief from pain and stiffness in the hands after wearing resting hand splints while sleeping. As a green lieutenant over 20 years ago, I began prescribing these splints for my clients with rheumatoid arthritis and osteoarthritis.
Thank goodness my clients convinced me of the universal benefits of resting hand splints to relieve arthritis pain before I read that they were only indicated for clients with rheumatoid arthritis! Since then, I have also found that clients with fibromyalgia and psoriatic arthritis benefit from resting hand splints. So, it’s not a randomized controlled study, but I always say hundreds of clients can’t be wrong.
Description of Arthritic Hand Pain
Clients with arthritis in their hands typically complain of achy pain and stiffness in most of the joints of both hands. Pain and stiffness are worst upon waking but gradually subside with warm water and movement. Pain tends to peak again in the evening or at the end of the work day. Symptoms are also worse with weather changes, such as a drop in the barometric pressure. Understandably, symptoms are worse with unusual or extensive use of the hands. Symptoms sometimes progress to constant achy pain.
Range of motion may be limited, especially on waking but improves over the course of the day. Strength is not typically a significant issue, though clients often report loss of strength. On further questioning, we are usually able to agree that it is pain, such as with gripping handles, that prevents them from doing the task, not loss of strength.
Resting Hand Splints
At my facility, we custom-make forearm-based resting hand splints from low-temperature thermoplastics. The forearm trough should be 2/3 to 3/4 the length of the forearm. The hand pan should allow the hand to be in a relaxed position with the fingers gently bent.
There are commercial padded splints on the market, but these tend to have a short forearm trough, which does not provide the correct biomechanical specifications and can put stress on the wrist.
Clients are directed to wear the splints at night while sleeping. Although some patients cannot tolerate wearing both splints every night, most clients do because they find them beneficial. Clients who are caregivers or on C-PAP tend to wear one splint a night, alternating.
Splints can be worn with light gloves, if desired, especially on a hand that you choose not to wear a splint on.
I prescribe resting hand splints for sleeping to my clients who complain of hand pain consistent with the above description. While most frequently, this is for clients with osteoarthritis and rheumatoid arthritis, I do prescribe them from time to time for clients with psoriatic arthritis and fibromyalgia. Patients with gout tend to have hand pain localized to a couple of fingers, and if anything, I would recommend a small hand splint.
Clients report that by wearing resting hand splints while sleeping, they experience decreased overall baseline achy pain and stiffness during the day. Through splints and contrast baths, they are able to work through their initial stiffness more quickly on waking and have less pain and stiffness during the day in normal daily activities. Splints are recommended for long-term usage, but many clients note that over time they find that they can sometimes alternate splints or wear splints 3 to 5 nights a week and maintain relatively pain-free use of their hands, given reasonable activities. Doing all of the Spring cleaning in 2 days is not reasonable.
I find that clients with osteoarthritis and psoriatic arthritis virtually always report significant benefits from resting hand splints. Clients with rheumatoid arthritis usually benefit. Sometimes, however, clients with autoimmune disorders such as rheumatoid arthritis or fibromyalgia have flair-ups and find very little relief from any strategies. Ultimately their rheumatologist finds the right medical management, and relief can then be quite swift.
I’m an avid believer in the benefits of resting hand splints to relieve arthritis, achy pain, and stiffness because my clients over the years have convinced me. They overwhelmingly report decreased symptoms. If you’re convinced, discuss resting hand splints with your doctor as a component of your comprehensive arthritis relief program. At most facilities, this would require a referral to occupational therapy.
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This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
rmcrayne (author) from San Antonio Texas on September 03, 2011:
Sandyjunep, try contrast baths, or the quicky version- alternating warm and cool water. Works like a charm. Read more here:
Sandyjunep from Australia on August 29, 2011:
Has anyone got ideas about pain in your fingers middle knuckles. I have just starting getting it and at times it is hard to bend
rmcrayne (author) from San Antonio Texas on January 30, 2011:
Yes Beege215e, expect good things. Resting hand splints, contrast baths, and joint protection strategies/reasonable activity make all the difference. Check out my hub on arthritis and contrast baths.
Beege215e on January 06, 2011:
I have not heard of these splints before so you have given me some very important information to take to my doctor. I have RA that has impacted my hands and fingers greatly, and while I am on medication I think these may be of value. Thank you for a great hub.
rmcrayne (author) from San Antonio Texas on September 02, 2009:
Christy, Absolutely! Tell, don't ask, your doctor you want a therapy consult to pursue strategies to include but not limited to splints.
rmcrayne (author) from San Antonio Texas on September 02, 2009:
Robert, You make an excellent point. I have coached many clients in TRYING to talk to their providers and to footstomp: this pain is same or different from my usual arthritis pain.
Christy8914 on August 30, 2009:
Having been a factory worker most of my life, I have had trouble with my hands for quite some time now. As you said upon awaking, my hands just ache. They are usually swollen, and even my skin feels too tight. The contrast baths help me during day and evening hours, but I always wake up hurting. Do you think the hand resting splint would help my morning pain? thank you
robertsloan2 from San Francisco, CA on August 29, 2009:
This makes sense to me. I've tried it and it doesn't help, but then, I have fibromyalgia and sometimes that's the hand pain. I'm learning to distinguish the flavors of pain from different things, paying attention to what it is in order to decide what to do about it.
Thank you for mentioning the circumstances it doesn't help with as much as for mentioning what it does help for. A lot of these things are very useful to people if they have that problem -- and if they don't cause harm they're worth trying once in order to see if it can help.