Patient preference and purpose of splinting (i.e. stability versus mobility) determine splint selection. Many patients find prefabricated neoprene splints more acceptable; therefore these may wish to be trialled first.
If adequate pain reduction is not achieved with a neoprene splint, the patient may wish to be referred to a hand therapist for assessment of suitability for a custom-made splint.
When to evaluate the splint’s effectiveness varies depending on whether the splint is worn during the day or at night. Day splints (prefabricated and custom-made) are associated with more rapid pain reduction (45 days in the study) than night splints, where benefits may not be seen for up to 12 months. Therefore, patients using a splint at night may only be able to evaluate effectiveness with persistent use (over months).
For ongoing day use, custom-made splints have shown better pain reduction in the longer term.
Some patients may achieve the best results by using more than one splint (e.g. a thermoplastic splint at night and a neoprene splint during the day).
Some patients do not achieve significant pain reduction with either day or night splints over the short or long term.