Wrist Supports for Arthritis, Carpal Tunnel and Weak Grip

Why wrists hurt in later life

• Osteoarthritis. Wear in the base of the thumb and the wrist causes pain with gripping and pinching, bony enlargement and stiffness.
• Inflammatory arthritis. Such as rheumatoid arthritis, with swelling, warmth and morning stiffness in both wrists; see osteoarthritis vs rheumatoid arthritis.
• Carpal tunnel syndrome. Pressure on the median nerve at the wrist causes tingling, numbness and pain in the thumb, index, middle and part of the ring finger, often worse at night and waking the person. It may follow repetitive tasks, thyroid problems, diabetes, pregnancy in younger women or wrist injury; see thyroid problems in older adults.
• Tendon problems. De Quervain's tenosynovitis causes pain at the thumb side of the wrist, particularly on lifting a baby or a kettle.
• Fractures and sprains. A fall on an outstretched hand is a common cause of wrist fracture in older people, especially with osteoporosis; see supports and braces after a fracture.
• Gout and pseudogout. Sudden hot, swollen wrists; see gout in older adults.
• Nerve and neck problems. Hand symptoms may come from the neck; see cervical collars and neck pain.
• Stroke and neurological conditions. A weak or floppy wrist may need a specific splint under therapist guidance.

Weak grip can also be due to muscle loss, poor nutrition, nerve disease or general frailty; see grip strength and hand exercises and sarcopenia, muscle loss and food.

Types of wrist support

Soft elastic wrist sleeve or band. A stretchy tube or band with light compression. Gives warmth and slight support, useful for mild arthritis aches and as a reminder to rest the wrist. Does not limit movement much.

Wrist wrap with Velcro straps. An adjustable fabric support with a stronger wrap, sometimes with a thumb loop. Easier to put on with painful hands, and can be loosened with swelling.

Wrist splint with a rigid or semi-rigid stay. A support with a firm plate, usually of metal or plastic, along the palm side (volar) or sometimes along the back, keeping the wrist in a neutral position. It is the typical carpal tunnel splint, worn at night or during activity. The wrist is held straight, since a bent wrist increases pressure on the nerve.

Thumb spica splint. A support that includes the thumb, used for thumb-base arthritis and De Quervain's.

Long forearm splints, which hold the wrist for greater stability after injuries or surgery, usually prescribed.

Resting hand splints. Used at night for inflammatory arthritis, as advised by a therapist.

Custom-made splints. Made of thermoplastic by an occupational therapist or hand therapist, moulded to the exact shape of the hand. They are best for complex needs, and not expensive in comparison with a poor-fitting product.

Compression gloves. Snug gloves that cover the hand and fingers, some with open fingertips, used to ease pain and swelling and warm stiff joints; see arthritis daily living gadgets.

Copper and magnetic bands. Evidence for special benefits is lacking.

Matching the support to the problem

• Carpal tunnel symptoms: a splint holding the wrist neutral, usually worn at night, sometimes in the day during provoking activities, for several weeks. Good evidence supports night splinting for mild to moderate carpal tunnel syndrome. See a doctor for diagnosis, since neck problems and diabetes can mimic or cause it.
• Arthritis pain with activity: a soft or semi-rigid support during tasks that hurt, such as gardening, kneading dough or lifting, then off for rest to avoid stiffness.
• Thumb-base arthritis: a thumb spica splint, often helpful for daytime use during painful activities.
• Sprain: a support for a short time as the doctor advises, followed by exercises.
• Weak grip with no joint problem: a support is rarely the answer; strengthening and aids are more helpful.
• After a fracture or surgery: only the splint prescribed by the treating team; see supports and braces after a fracture.

How to choose and fit

1. Get a diagnosis if symptoms are new, persistent or involve numbness or weakness. 2. Choose the correct side. Wrist splints are often made for the right or left hand. Check. 3. Measure. Most are sized by wrist circumference, measured around the wrist bone with a soft tape, and sometimes by hand circumference. Follow the maker's chart. 4. Check the fit. It should hold the wrist in a comfortable, neutral position: not bent forward or back. The fingers should move freely, and the thumb crease should not be blocked, unless it is a thumb splint. The edges should not dig in. 5. Check the fabric. Breathable, cotton-lined materials suit humid climates. Neoprene retains heat and sweat; do not use it if your skin is sensitive. 6. Make sure you can put it on. Hand pain and weakness can make Velcro and straps hard. Choose easy-grip tabs or ask for help; see dressing aid guide. 7. Washability. Machine or hand washable, with metal stays removable. 8. Check the stay. The splint should have a firm but gently contoured support that can be bent by a therapist to fit your wrist, if adjustable. 9. Try before you buy, where possible, or buy from a seller with a return policy.

Wearing it well

• Put it on with clean, dry skin. Smooth wrinkles.
• Snug, not tight. Tingling, colour changes, swelling in the fingers or increased pain mean it is too tight or wrongly positioned.
• Carpal tunnel splints: wear as directed, commonly at night. Do not wear tight splints for too long without breaks, which may cause stiffness. Therapist advice is best.
• Activity splints: wear for tasks that hurt, and take off for rest and gentle exercises, as taught.
• Do not rely on it for lifting heavy loads. Use both hands, and use tools to reduce force; see jar opener and kitchen aids and easy grip cutlery guide.
• Keep fingers moving to avoid stiffness. Do gentle finger and wrist exercises as taught; see grip strength and hand exercises.
• Check the skin daily for redness, pressure marks, rashes or blisters. Dry the skin well after sweating or washing.
• Wash the support regularly, and have a spare.
• Replace when it is stretched out, misshapen or dirty.

Everyday tips for painful or weak wrists

• Use the larger joints: carry with forearms, not fingers; push doors with the shoulder.
• Neutral wrist: avoid bending the wrist while typing, writing or using a phone for long; see phone and remote aids for arthritis and phone accessibility features for seniors.
• Built-up handles on utensils, pens and tools.
• Lightweight pots, a kettle tipper, and jug with two handles.
• Share and pace tasks; take breaks.
• Warm water soaks may ease stiffness; see heat or cold for joint pain.
• Avoid sleeping on the hands and with wrists tightly bent.
• Watch for diabetes and thyroid; these conditions are linked with carpal tunnel and hand problems; see diabetes at home after 60.
• Medicines: talk to a doctor or pharmacist before using tablets or gels; see painkillers and older adults.
• Falls: to reduce wrist fractures, address falls risk and bone health; see falls risk assessment at home and osteoporosis home care guide.

When to ask a professional

See a doctor for numbness or tingling that persists or wakes you at night, a weak or dropping grip, a hot, red or swollen wrist, pain after a fall or injury, a deformed wrist, or symptoms in both hands, since other causes need to be excluded. An occupational or hand therapist can make a custom splint, teach joint protection and suggest tools. A physiotherapist can advise on exercises. A surgeon can advise if symptoms continue or worsen, with options such as injection or surgery. A pharmacist can advise about skin irritation from supports.