This article explores the best thumb splints that I’ve found for thumb base osteoarthritis. I'm not going to discuss the condition itself as I've covered that in detail in this article. There, you can learn all about thumb arthritis including all of the other evidence based treatments available for it. Here I'm going to concentrate on thumb splints and take an in-depth look at the best ones that I’ve found over the years.
The information is also available in video format below, including fitting instructions for each splint.
The purpose of a splint is to support the arthritic joint while still allowing some movement and hand function. Some splints will provide minimal support and therefore still allow a lot of movement and others will provide lots of support but not allow much movement at all, and what works best for you will be the splint that provides enough support to help reduce your pain while still allowing enough thumb movement so can use you hand for the things you need to do.
For example, If your hand was in a full cast then no thumb movement occurs and you therefore have no pain, but you can't use your hand - so thats no good. At the other end of the spectrum, a piece of tubigrip will provide hardly any support but will allow almost full thumb movement. It’s a trade off and what works best for you will depend on your symptoms and the activities you need to be able to do while wearing the splint.
Splint 1
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| Fabric Thumb Splint - Amazon Link |
This first splint is a good starting point as it is inexpensive and provides a decent amount of support while still allowing a good range of thumb movement. It's made of fabric, but with a supportive bar that runs along the thumb. It's secured with a Velcro strap around the wrist and another one around the thumb tip. It comes in different sizes depending on your wrist circumference.
The splint below is very similar but more hard wearing and therefore recommended for longer term use.
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| Fabric Splint 2 - Amazon Link |
Splint 2
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| Ligaflex Thumb Splint - Amazon Link |
If your arthritis is more severe or you need a splint with more support then the next one I can recommend will do just that but it will restrict your thumb movement a bit more. This one is again made mainly of fabric but it has a plastic wedge that sits between the thumb and index finger. It's secured with a wrist strap and thumb tip strap. It’s a bit more compact than the last one and also more hard wearing. This particular one comes in 2 sizes : size 1 for wrists of 13-17cm and a size 2 for wrists between 17 and 23cm.
Splint 3
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| Push CMC Thumb Splint - Amazon Link |
The Push CMC Thumb Splint is probably the best splint that you can currently buy as an off-the-shelf thumb base splint but it is quite a bit more expensive than the others. It also very sleek and compact. It was developed by hand therapists and I think it offers the best overall compromise of support and function. So if you want the best available splint that I’ve seen over the years, then this is it. It has a firm plastic piece that neatly surrounds the whole thumb base region and it secures with 2 wrist straps. 3 sizes are available depending on your hand span measurement. It’s quite compact and it doesn’t interfere with wrist movement. It supports the thumb base joints very well while still allowing a good degree of overall hand movement.
Splint 4
All the previous splints are all off-the shelf, and so if your thumb isn’t the typical shape then they might not fit you comfortably and they might cause some pressure. This can particularly happen if your arthritis is late stage and you’ve developed a degree of thumb base squaring. In this case the angled edge of the thumb can rub against the splint and become uncomfortable.
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| Thumb Base 'Squaring' |
So if this is you, and you can’t find a splint to fit then I would consider my last recommendation, which is a bespoke custom made splint that is moulded to the individual shape of your thumb. These are usually made of a thermoplastic which becomes malleable in hot water so it can be moulded, and when it cools it hardens and retains its shape.
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| Custom Made Thumb Splint |
For a custom made splint, you’re going to need to see a Hand Therapist who are usually Occupational Therapists, Physiotherapists or Physical Therapists who have specialised in hand therapy. Some Orthotists will also provide this service.
How to use a Thumb Splint
Whichever splint you choose, when you first start wearing it you should try to use it for most of the time, even at night if the pain is keeping you awake. The idea is to give your thumb as much rest as possible and allow it to calm down. About 6 weeks of maximum use is usually needed. Take it off when washing your hands and doing some gentle exercises to prevent stiffness but otherwise, leave it on for the rest of the time.
After about 6 weeks, if it's working well, your thumb pain should have improved and you can now start slowly weaning off the splint over a few weeks. During this time, one of 2 things will happen :-
1) You might be lucky and the thumb pain might have settled down and as long you can avoid the strenuous activities that aggravated it in the first place, it might stay pain free.
2) Your thumb pain might return as you start reducing the splint use. If that happens then you might need to continue using the splint for the long term but use it just as much as you need to in order to keep the symptoms at bay. You will have discovered the right amount of time for you during the weaning process.
And if you do need to wear a splint for the long term then I would suggest one of the more durable ones that we talked about earlier, as the cheeper fabric ones will tend to wear out and overall it becomes false economy to keep replacing them.
Links to all of the splints I’ve talked about can be found by clicking the pictures above.
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