I have found overwhelmingly that clients with arthritis experience relief from arthritis pain and stiffness in the hands after wearing resting hand splints for sleeping.  As a green lieutenant over 20 years ago, I began prescribing these splints for my clients with rheumatoid arthritis as well as those with 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 that time, 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. 

Clients with arthritis in their hands typically complain of achy pain and stiffness to most of the joints of both hands.  Pain and stiffness are worst on waking, but gradually subside with warm water and movement.  Pain tends to peak again in the evening or 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. 

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. 

INDICATIONS

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 fingers, and if anything I would recommend a small hand splint.

BENEFITS

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, 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.

SUMMARY

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.