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How to Choose a Thumb Splint

From Dr. Z - Carpal tunnel syndrome specialist

What to Look for in a Thumb Splint

A thumb splint is a specialized brace with a thumb support or "spica". Many people wear a thumb splint to stop hand or thumb pain. It's also often used after thumb surgery.


A thumb splint is designed to keep the thumb immobile. If that's not absolutely required, then a thumb splint is not necessary. Usually, an ordinary brace will be fine for most disorders like arthritis, sprains, de Quervain's, or post surgical fixation. It should not be used for carpal tunnel syndrome. (See last section below.)

What’s a thumb splint for?

Almost every thumb splint is essentially a hand brace with added support to the injured thumb. It can be in the form of a brace that restricts all of the fingers or one that restricts only the thumb using a "spica" (technically called a thumb spica). 


The main purpose of this splint is to keep the thumb immobilized while it heals from injury or disease. By far, the most common reason to wear a thumb splint is either for a thumb sprain or for de Quervain’s tenosynovitis.

thumb brace and spica

Other conditions that might require a thumb splint are:

 

  • Post-operative
  • Osteoarthritis
  • Thumb fracture
  • Wrist tendonitis
  • Gamekeeper’s Thumb
  • Skier’s thumb

The thumb spica

Every thumb splint has a thumb spica incorporated directly into the brace's structure. It can be a rigid or semi-rigid extension of the hand brace that specifically supports the thumb. 


In medical terms, the spica is an orthosis, meaning it was designed to keep the thumb stable and in one position. Some braces incorporate a thumb spica specifically for post-surgical rehabilitation or as a substitute for a hand cast. They may include a simple Velcro-locked spica support or a lace-up spica. 


Several thumb spica types are bendable to conform to the angle in a person’s thumb, or as the doctor requires for maximum healing. Newer thumb splints with a spica have a moldable plastic spine. You can mold and adjust it with a just little heat (from a hairdryer) into the precise shape and angle you need.

wrist brace with thumb spica

Thumb splint for sprains

You can sprain a thumb if you bend it too far, beyond its normal range of motion. Too much bending will disrupt the ligaments that support the thumb.


Beyond their physical limits, ligaments can develop micro-tears. This causes inflammation and swelling – and of course, severe pain. 


The most common injuries occur in association with contact sports like football and basketball. The most severe cases require surgery to join completely ripped ligaments in the thumb. 


Whether you need a thumb splint for post-surgical support or for support after a minor injury (like a partial tear), the thumb splint with a spica will help keep your thumb from moving excessively. This lets your thumb rest. That rest allows it to mend better in the 4-6 weeks that most thumb ligaments require to heal completely.

hand doing Finkelstein test

Thumb splint for de Quervain’s tenosynovitis

With simple diagnoses now available, it's common today for doctors to identify the condition known as de Quervain’s tenosynovitis. This is essentially tendinitis at the base of your thumb. 


It occurs in one of several ways. It's common with arthritis, after trauma to the thumb, and repetitively and forcefully gripping and releasing objects. If you have this condition, moving your thumb while grasping or making a fist will cause pain. 


The Finkelstein test can determine if you have this condition. Bend your thumb across your palm, then close your fingers over the thumb. Next, bend your wrist toward your little finger. This will cause pain at the base of your thumb if you have de Quervain’s tenosynovitis.


The most severe cases of de Quervain’s tenosynovitis will require surgery. However, in the majority of cases the disorder is treatable with cortisone injections and bracing. A thumb splint with a spica will help rest the thumb while the other fingers can work, if only in a limited way. For maximum benefit you must wear the splint day and night, generally for 4-6 weeks.

hand using garden shears

Thumb splint for carpal tunnel?

Never use a thumb splint if you have carpal tunnel syndrome. Carpal tunnel is s special disorder which requires a special combination of treatments. One of them is a certified carpal tunnel brace.




These are braces designed without a metal spine on the palmar surface. Also, you must wear this brace only at night but not during the daytime.


Wearing this special carpal tunnel brace is crucial to properly treating this condition. It is one part of a 4-part regimen which includes rest & avoidance, night bracing, stretching exercises, and myofascial massage.

Conclusion

A thumb splint is a special type of splint or brace that immobilizes your thumb. A metal spine (or spica) holds the thumb in a desired position. A thumb splint is usually used for de Quervain’s tenosynovitis or a sprained thumb. Never use one for carpal tunnel syndrome.

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