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Splints May Provide Temporary Psoriatic Arthritis Relief
While splints can play a role in psoriatic arthritis management, therapists caution that limited use is best.
By Elizabeth Connor
Medically Reviewed by Sanjai Sinha, MD
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For some people coping with the discomfort of psoriatic arthritis, using a splint to immobilize a tender joint can seem like an attractive option. But the decision to use a splint is more complicated than it first seems.
In its simplest form, a splint is a rigid or semirigid material placed around a joint to keep it from moving. Not only does the splint protect the joint from injury, but the immobilization can also help reduce pain and swelling from conditions like psoriatic arthritis. Wrist splints are commonly used for arthritis.
There are few clear-cut guidelines for when to use a splint, and the decision is often heavily influenced by the patient’s preference. For their part, doctors who treat arthritis patients say splints should be used judiciously.
When Should a Splint Be Used?
“Splints, by definition, put a joint at rest,” explains , rheumatologist with Seattle Rheumatology Associates in Washington and clinical professor at the University of Washington School of Medicine. “What that means is that the muscles around that joint will lose some of their tone and become weaker.”
To slow or avoid the atrophy of muscle tissue when an arthritis patient does use a splint, physical therapists will suggest isometric exercises, in which the muscle contracts without changing its length.
“There’s a balance between splinting a joint to protect it and maintaining tone by doing isometric exercises of the muscles around that joint. We have physical and occupational therapists teach patients to do isometric toning exercises for those muscles in specific ways so the person doesn’t hurt that joint,” Dr. Mease says.
Lorinda Chung, MD, associate professor of medicine and dermatology at Stanford University School of Medicine in Palo Alto, California, says splints are generally avoided for arthritis patients, but notes that exceptions are made for two conditions: tenosynovitis, an inflammation of a tendon and the sheath that surrounds it; and carpal tunnel syndrome, a painful condition in which the medial nerve at the top of the wrist becomes squeezed.
“Carpal tunnel syndrome is very common in patients with arthritis because the joint space in the wrist may be narrowed from swelling, leading to pressure on the median nerve,” Dr. Chung says.
One type of tenosynovitis is de Quervain's syndrome, which involves a noninflammatory thickening of the muscles that run alongside each other through the thumb and function to bring it away from the hand. "So we use thumb splints for de Quervain's tenosynovitis, and we use wrist splints for carpal tunnel syndrome," Chung says. "Beyond that, we don’t encourage splint use because we don’t want them to lose mobility."
Proper Use of a Splint
The limited research on how patients use splints suggests that they frequently don't use them consistently or appropriately. These guidelines can help both patients and their doctors ensure that a splint provides the most effective joint protection possible:
- You and your physical therapist should agree on the goals of using the splint, and you should clearly understand the therapy.
- Be involved in the selection of your splint.
- Be sure to have your splint fitted by an expert.
- Get written and verbal instructions for the splint’s use.
- You and your therapist should discuss and address any problems with wearing the splint.
- Keep a daily log of how you use the splint — you and your therapist can refer to this if you have any concerns or problems during treatment.
- Have the splint reevaluated after the first week and adjusted, if necessary.
Regardless of which splint you use, it's important to understand how long you'll need to wear it, and to set your expectations accordingly.
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