By Ronnie Cohen
NEW YORK (Reuters Health) - Inexpensive splints worn nightly can reduce the pain of hand osteoarthritis, a chronic ailment that affects a majority of older adults, a new study shows.
"It's a well-tolerated, safe and cheap intervention," rheumatologist Dr. Fiona Watt told Reuters Health.
Watt, from the Arthritis Research UK Centre for Osteoarthritis Pathogenesis at the University of Oxford, led the new study. She and her colleagues tested custom-made splints on London clinic patients who suffered painful and deforming hand osteoarthritis.
Up to 70 percent of adults 55 years and older have hand osteoarthritis, the authors write in the journal Rheumatology. The condition can include episodes of persistent and debilitating pain, limit hand use and erode quality of life.
Previous research has shown splints cut hand arthritis pain (see Reuters Health story of January 27, 2011 here: reut.rs/1hz5IAe). One study found that hand pain was halved for patients who wore a long and rigid splint every night for a year.
In the current study, hand therapists fashioned rigid splints out of $5 to $6 worth of thermoplastic for one arthritic finger joint per patient, and patients wore the splints nightly while sleeping for three months, Watt said.
Twenty-six patients, mostly women, were included in the study. Of the 23 who completed the study, 17, or 74 percent, reported reduced pain after wearing the splints for three months, the study found.
Three months after patients stopped wearing the splints, their average pain was significantly lower in splinted joints than in their other arthritic finger joints that had not been splinted.
Watt said she was surprised to see continued benefits three months after patients stopped using the splints.
"It might suggest that this is a modification of the disease that extends beyond the use of the splint," she said.
The majority of the patients, 61 percent, chose to continue to use the splints when the study was completed, "which is a good sign, probably better than any statistics," Watt said.
Dr. Prosper Benhaim, hand surgery chief at UCLA Medical Center in Los Angeles, told Reuters Health he had successfully used similar splints on his patients' thumbs.
Benhaim was not involved in the new research and has not splinted his patients' farthest finger joints, as was done in the current study. But he said the study convinced him to try.
"Wearing a splint when you're sleeping actually seems to work," he said. "It's so simple. When you're asleep, it's free time. There's no inconvenience."
Why splinting relieves arthritic pain is not well understood, the study authors write.
Benhaim believes nighttime splints work because they reduce inflammation. Arthritis stems from a combination of inflammation and a loss of cartilage.
"It just repositions the fingers into a more relaxed position," Benhaim said.
He said a Popsicle stick and a Band-Aid could work just as well as the thermoplastic splints used in the new study.
But a doctor or a physical therapist will know best how to size and fit a splint, he said.
SOURCE: http://bit.ly/1ciuO2P Rheumatology, online February 8, 2014.