Splinting for Asymptomatic Wrist Arthritis
You do not need to use a splint if you have no pain or functional limitations from your right wrist arthritis. Splints are primarily indicated to reduce pain and improve function during activities, not as a preventive measure in asymptomatic joints.
Guideline-Based Rationale
The 2022 American College of Rheumatology guidelines provide a conditional recommendation for splinting in patients with hand and/or wrist involvement and/or deformity, but this recommendation is specifically based on evidence showing improvement in pain and physical function 1. The guidelines explicitly state that splinting is intended to "reduce pain and improve physical function" 1.
When Splinting Becomes Appropriate
Splinting should be considered when you develop:
- Pain during activities of daily living that impedes functioning 1
- Joint instability affecting hand use 1
- Functional limitations requiring support during specific tasks 1, 2
- Active inflammation with swelling 3
Evidence on Splint Use Patterns
Research demonstrates that patients with rheumatoid arthritis primarily wear splints for:
- Activities requiring greater strength rather than continuous wear 4
- Pain relief during symptomatic periods 5, 6
- Support during heavier activities 4
Studies show that working wrist splints do not affect pain or morning stiffness when worn prophylactically, and patients report preferring to use splints only when symptomatic 3.
Important Caveats
If you develop symptoms in the future, splinting should be prescribed and fitted by an experienced occupational or physical therapist to ensure appropriate selection and fit 1. Custom-fitted splints are more effective than commercial options for pain reduction (reducing pain from 4.1 cm to 2.8 cm on visual analog scale) 6.
Joint protection techniques and hand exercises may be more appropriate than splinting for asymptomatic arthritis, as these interventions help maintain function throughout the disease course 1, 2.