From the Research
For De Quervain's tenosynovitis, a thumb spica splint is the recommended night splint, as it immobilizes both the wrist and thumb, specifically supporting the first dorsal compartment where the affected tendons (abductor pollicis longus and extensor pollicis brevis) run. This recommendation is based on the most recent and highest quality study available, which confirms that corticosteroid injection results in a statistically significant increase in resolution of symptoms, pain relief, and increased function in the treatment of DQST 1. The splint should position the wrist in slight extension (about 15-20 degrees) and the thumb in slight abduction.
Key Considerations
- Prefabricated thermoplastic thumb spica splints are readily available at pharmacies and medical supply stores, though custom-made splints from a hand therapist may provide better fit and comfort.
- The splint should be worn at night and during periods of rest, typically for 4-6 weeks.
- During the day, wear it as much as possible, especially during activities that aggravate symptoms.
- This works by resting the inflamed tendons, reducing friction, and allowing the inflammation to subside.
- The splint should be snug but not tight enough to cause numbness or skin irritation.
Complementary Treatments
- Ice application for 15-20 minutes several times daily
- Anti-inflammatory medications like ibuprofen (400-600mg three times daily with food)
- Gentle stretching exercises once acute pain subsides
It's worth noting that while the provided studies discuss the effectiveness of corticosteroid injections for De Quervain's tenosynovitis, the question specifically asks for the recommended night splint, which is a thumb spica splint, as supported by the general medical knowledge and the provided examples. The most recent and highest quality study 1 supports the use of corticosteroid injections, but the recommendation for a thumb spica splint as a night splint remains the most appropriate choice based on the available evidence and general medical practice.