Wrist splints in rheumatoid arthritis: a question of belief?

Wrist splints are often used in the treatment of rheumatoid arthritis (RA). We applied a questionnaire to RA patients and rheumatologists to assess wrist splint use and to assess the policy of prescription. We related the reported use to patient satisfaction, severity of disease and physician's advice. Of 44 RA patients admitted to our hospital in 1990, 32 received one or more splints. Most patients (23) had both a wrist immobilization splint and a wrist activity splint (Futuro cock-up splint). The response rate to the questionnaire sent to all (n = 109) Dutch rheumatologists was 83%; 89 of 91 rheumatologists prescribed splints. Each rheumatologist prescribed yearly a mean of 30 immobilization splints (min-max: 2-120) and 51 activity splints (min-max: 4-170). Both types were mainly prescribed to relieve pain and reduce inflammation. From the patients' point of view, only the wrist activity splints were worth regular and continued use. Our findings suggest that if one prescribed splints, more attention should be paid to patient education and compliance.