From the Research
The best splint for De Quervain's tenosynovitis is a thumb spica splint that immobilizes both the wrist and the thumb, specifically when used in combination with corticosteroid injection, as evidenced by the most recent and highest quality study 1. This approach has been shown to offer superior pain relief and functional outcomes compared to using a thumb spica cast alone. The splint should be worn continuously for 2-6 weeks, removing it only for hygiene purposes, and should position the thumb in slight extension and the wrist in neutral or slight extension. Key features of an optimal splint include ergonomic thumb support and evenly distributed pressure, which can be achieved through the use of both hard and soft materials, as proposed in a recent study 2. For optimal recovery, combine splinting with rest, ice application for 15-20 minutes several times daily, and anti-inflammatory medications like ibuprofen (400-600mg three times daily with food) or naproxen (250-500mg twice daily with food) for 1-2 weeks. The splint works by preventing the painful gliding of inflamed tendons through the narrow first dorsal compartment, giving the tendons time to heal while reducing friction and subsequent inflammation. It is also important to note that custom-made thermoplastic splints fitted by a hand therapist can provide the best results, though pre-fabricated thumb spica splints available at pharmacies can also be effective, as supported by earlier studies 3, 4, 5.