What is the best wrist brace for treating wrist tendonitis?

Best Wrist Brace for Wrist Tendonitis

For wrist tendonitis, a custom-made orthosis that includes both wrist and thumb support is strongly recommended as the most effective option for pain relief and functional improvement. 1

Types of Wrist Braces and Their Effectiveness

Full vs. Partial Splints

• Full splints (covering both thumb base and wrist) provide significantly better pain relief than half splints (only protecting the thumb base) with an effect size of 0.64 2
• The pooled Number Needed to Treat (NNT) for improvement in daily activities is 4 with full splints 2

Dorsal vs. Volar Splints

• Dorsal wrist splints allow for better hand function during daily activities while still providing support 3
• A study of 65 patients showed that 37 were able to perform housework and job activities while wearing dorsal wrist splints 3
• Dorsal lock wrist hand orthoses showed significant improvement in pain and neurological symptoms when maintaining the wrist in neutral position 4

Custom vs. Prefabricated

• Custom-made orthoses are recommended over prefabricated ones to improve patient compliance and long-term use 1
• Custom orthoses provide better pain relief and functional improvement 1

When and How to Use Wrist Braces

Optimal Usage Pattern

• Wrist bracing should be limited to periods of no to light activity 5
• Avoid wearing splints during tasks requiring heavy efforts, as this can increase extensor muscle activity by 7.9-23.9% MVE (Maximum Voluntary Effort) 5
• At low-to-moderate grip forces, splints can support the wrist against external loading 5

Position Recommendations

• Maintaining the wrist in a neutral position is most effective for reducing pain and neurological symptoms 4
• The brace should be designed to be less cumbersome while still maintaining accurate positioning for the wrist and distal joints 4

Management Algorithm for Wrist Tendonitis

1. First-line treatment: Custom-made orthosis that includes both wrist and thumb support 2, 1

   • Preferably a dorsal design that maintains the wrist in neutral position 4, 3

2. Complementary treatments:

   • Topical NSAIDs (particularly diclofenac gel) for pain management 2, 1
   • Kinesiotaping as an alternative when range of motion is needed 2

3. When to wear:

   • During periods of rest and light activity 5
   • Remove during heavy gripping or high-force activities 5

Special Considerations

• Athletes with wrist tendonitis: May benefit from specialized bracing that allows for sport-specific movements while still providing support 6

• Common pitfall: Using a brace that's too restrictive during activities requiring fine motor skills or grip strength can be counterproductive 5

• Important caveat: Patients with wrist tendonitis will likely benefit from evaluation by an occupational therapist for proper fitting and selection of the most appropriate orthosis 2