De Quervain’s tenosynovitis is a condition that affects the tendons on the thumb side of the wrist, causing pain. It involves inflammation of the sheaths surrounding two specific tendons, the abductor pollicis longus and extensor pollicis brevis, which help move the thumb. This inflammation can cause tenderness and swelling at the base of the thumb and wrist, often worsened by grasping or pinching movements. Splinting is a common non-surgical approach used to manage its symptoms.
Role of Splinting in Managing De Quervain’s
Splints are used for De Quervain’s tenosynovitis primarily to provide mechanical support and restrict movement of the affected thumb and wrist. By immobilizing these areas, a splint helps reduce friction and irritation within the inflamed tendon sheaths. This reduction in movement is intended to lessen the inflammation and pain associated with the condition. Consistent support from a splint allows irritated tendons to rest, promoting natural healing.
Common Splint Types for De Quervain’s
The most common splint for De Quervain’s tenosynovitis is the thumb spica splint, also known as a thumb spica orthosis. This type of splint is designed to immobilize the carpometacarpal (CMC) and metacarpophalangeal (MCP) joints of the thumb, while also providing support to the wrist. It restricts motions that worsen the condition, such as grasping or pinching.
Thumb spica splints are available as off-the-shelf or pre-fabricated options. These are often more affordable and can be purchased without a custom fitting. While convenient, their general sizing may not provide the most precise fit or optimal immobilization.
Custom-made thumb spica splints offer a tailored approach, as they are molded specifically to an individual’s hand and wrist. This customization allows for a more exact fit, which can enhance comfort and maximize immobilization of affected tendons. However, custom splints are more expensive and require professional fabrication. They are commonly made from materials like thermoplastic, which can be heated and shaped, or from softer materials such as neoprene or fabric for less rigid support.
Choosing the Most Suitable Splint
Selecting the most suitable splint for De Quervain’s tenosynovitis depends on several individual factors. The severity of symptoms, including whether the pain is acute or chronic, plays a role in determining the level of immobilization needed. An individual’s daily activities and the degree to which they require thumb and wrist movement also influence the choice of splint.
Achieving a comfortable and proper fit is important to ensure the splint effectively supports the wrist and thumb without causing further irritation or nerve compression. An ill-fitting splint can lead to new problems or reduce compliance with wearing it. Consulting a healthcare professional, such as a doctor, physical therapist, or occupational therapist, is recommended for accurate diagnosis and personalized splint recommendation. These professionals can assess specific needs and often provide custom fitting or guidance on selecting an appropriate pre-fabricated model.
Effective Splint Use and Care
Proper use and maintenance of a splint are important for optimal results in managing De Quervain’s tenosynovitis. The duration of wear can vary; some individuals need to wear the splint continuously, while others may only wear it during activities that aggravate their symptoms or at night. A healthcare professional provides guidance on the recommended wearing schedule.
Maintaining hygiene is also important; the splint and skin underneath should be kept clean to prevent irritation or breakdown. Most splints can be cleaned with mild soap and water. The skin should be regularly checked for any signs of redness, pressure points, or discomfort. Individuals should routinely check the splint’s fit to ensure it remains snug but not overly tight. Signs such as numbness, tingling, increased pain, or persistent skin redness indicate the splint may need adjustment or re-evaluation by a professional.
Other Treatment Approaches
Splinting is one part of a treatment plan for De Quervain’s tenosynovitis. Other non-surgical interventions are often used alongside it. Resting the affected hand and modifying aggravating activities reduce strain on the tendons. Applying ice to the inflamed area can help decrease swelling and pain.
Over-the-counter or prescription anti-inflammatory medications, known as NSAIDs, can manage pain and inflammation. Physical or occupational therapy provides exercises, stretches, and ergonomic advice to improve hand and wrist mechanics. In some cases, corticosteroid injections directly into the tendon sheath can provide relief from inflammation. Surgery is a last resort for persistent cases that do not respond to conservative treatments.