Hands and splinting

Why hands and wrists are affected

Inflammatory arthritis such as rheumatoid arthritis often targets the small joints of the hands and wrists. Osteoarthritis tends to affect the base of the thumb and the end and middle finger joints. Both can cause pain, stiffness, swelling, and a weaker grip, and nerve problems such as carpal tunnel syndrome can add tingling or numbness.

What helps

• Keep the wrist straight (neutral) for gripping and lifting, and avoid a long, tight pinch.
• Built-up grips and lighter tools reduce the strain on sore finger joints.
• Take breaks from gripping, typing, and phone-scrolling, and shake out and stretch the hands regularly.
• Warmth before activity, and for some a cool pack after a flare, can ease the joints.

Gentle hand exercises

Kept within comfort, gentle movement keeps the hands supple and the grip working. Your team can tailor these to you, but common ones include slowly making a loose fist and then opening the fingers wide, touching the thumb to each fingertip in turn, and gently bending the wrist up and down. Move smoothly, stop short of pain, and do a little and often rather than long sessions.

Splints that can help

• A night resting splint holds the wrist and hand in a comfortable neutral position and can ease morning pain and stiffness in inflammatory arthritis.
• A thumb-base (CMC) splint supports the joint at the base of the thumb, a common site of osteoarthritis, during pinching and gripping.
• A wrist working splint supports the wrist during aggravating tasks while leaving the fingers free.

Using a splint well

• Wear it as advised, often at night or during aggravating tasks rather than around the clock, so the muscles stay active.
• It should feel supportive, not tight or numbing; loosen it if the fingers tingle or go cold.
• Keep the skin clean and dry underneath.

When to seek help

Contact your team if numbness is constant, if the hand feels weak or you are dropping things, or if pain and swelling are not settling. An occupational therapist can fit the right splint and tailor a technique and exercise plan to your hands.