MSK injury? Make splinting choices based on the evidence
Which devices do—and don’t—have evidence to support their use when it comes to injuries like carpal tunnel syndrome, “tennis elbow,” or an ankle sprain? Read on.
PRACTICE RECOMMENDATIONS
› Consider a wrist splint for carpal tunnel syndrome secondary to repetitive motion. B
› Recommend a simple knee sleeve to help patients with osteoarthritis reduce their pain and improve daily function. B
› Use ankle bracing for secondary prevention of a recurrent ankle sprain. A
Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
From The Journal of Family Practice | 2018;67(11):678-683.
Harms: No documented harmful adverse effects (AEs) have been reported with splinting for this condition.
Bottom line: A thumb spica splint remains an option for de Quervain tendinopathy. It may provide symptomatic relief, especially if used early in the disease, but does not alter the natural disease course.
Lateral/medial epicondyle pain
Also known as tennis/golfer’s elbow, lateral/medial epicondyle pain is thought to result from overuse of the common wrist extensor/flexor muscle origins at the site of the myotendinous junctions.
Goal of splinting: To dampen or disperse the forces at the painful area via a counterforce brace (FIGURE 3). In addition, braces are used to decrease wrist use, specifically extension or flexion.
Evidence: A 2002 Cochrane Review found insufficient data to support the use of counterforce braces for relief of acute or chronic pain symptoms associated with epicondyle pain.Several studies supporting their use within this review were of varying quality with weak evidence.12
Continue to: Volar wrist braces have also been...
