Orthoses for Painful Fingers

Osteoarthritis (OA) is a chronic disease which can result in painful joints and limited functional ability. OA of the hand is the most common and affects women three times more than men.

Most articles and studies have looked at interventions for OA of the thumb CMC joint. But painful fingers can also cause a variety of functional deficits, which include:

• Decreased grip and pinch strength
• Decreased range of motion
• Decreased performance during everyday activities

Luckily, there are various therapeutic interventions, including orthotic fabrication, that can ease painful fingers and help patients to carry on with their day-to-day activities.

Orthotic Fabrication for Fingers: Current Research

A recently published systematic review (Beasley et al, 2019) in the Journal of Hand Therapy evaluated the evidence for therapeutic interventions specifically for finger joints with osteoarthritis. This is the first systematic review to target interventions for the proximal inter-phalangeal (PIP), distal inter-phalangeal (DIP), and thumb inter-phalangeal (IP) joints.

The review focused on finger joint interventions that included:

• AROM exercises
• Thermal modalities
• Laser therapy
• Joint protection techniques
• Yoga
• Orthotic fabrication

Decreasing pain is the main focus of these therapeutic interventions.

Only two of the eighteen studies reported on the use of orthoses to manage symptoms of finger joints with OA. Ikeda et al (2010) and Watt et al (2014) both evaluated the use of orthoses for the distal interphalangeal joint. These two studies demonstrated that wearing a customized DIP orthosis significantly reduces pain in finger joints with OA.

Clinicians can reference the information provided by systematic reviews such as this one and also use good clinical judgment to choose appropriate patient-centred treatment options.

Material Choices for Finger Orthoses

Choose lightweight thermoplastic materials to fabricate comfortable orthoses for painful fingers. The following can all be used to make excellent finger orthoses:

• Orfilight (NS) in 2.5 mm (1/12”) and 1.6 mm (1/16”)
• Orficast and Orficast More
• Orfit Classic
• Aquafit NS (Orfit Natural NS)
• Orfit Colors NS

Instructional Videos

Take inspiration from below orthotic fabrication videos demonstrating effective designs for finger orthoses in Orficast:

Anti-swan neck orthosis (rolled oval 8):

Anti-swan neck orthosis (pinch method):

Full finger pinch:

Full finger wrap:

Reference:

Beasley, J., Ward, L., Knipper-Fisher, K., Hughes, K., Lunsford, D., & Leiras, C. (2019). Conservative therapeutic interventions for osteoarthritic finger joints: A systematic review. Journal of Hand Therapy. Vol. 32;153-164.

Written by Debby Schwartz, OTD, OTR/L, CHT

Physical Rehabilitation Product and Educational Specialist at Orfit Industries America.

Debby is a certified hand therapist with over 36 years of clinical experience. She completed her Doctorate of Occupational Therapy at Rocky Mountain University of Health Professions in 2010. She has worked at Orfit Industries America as Product and Educational Specialist since 2007.

Debby is also an adjunct professor at the Occupational Therapy Department of Touro College in NYC and has written many book chapters in the field of hand therapy and multiple articles for hand therapy journals, including the ASHT Times and the Journal of Hand Therapy. She has published a new textbook on orthotic fabrication together with Dr. Katherine Schofield, entitled “Orthotic Design and Fabrication for the Upper Extremity: A Practical Guide”.

Debby’s Google Scholar

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