My recommendations for wrist supports to prevent subluxation and clenching at night.
I have a pain response where I tightly clench my fist and arm in my sleep. This causes my wrist to sublux (joint pops partially out) and stretches and irritates my median nerve, which was damaged in an accident. Both of these things cause more pain and perpetuate the cycle so a year ago my doctor recommended wearing a wrist splint at night to prevent these things from happening.
Recently I had to replace my splint and was a bit bewildered by all the different options, so I have tested and reviewed six supports below. All the splints cover the palm and include a metal bar up the inside of the wrist and bent into the palm. It’s more comfortable than it sounds and the bar helps to stop the fist from folding in towards the arm. When putting a splint on I clench my fist and arm muscles with my arm straight so that I won’t make the splint too tight or restrictive.
In an ideal world, consult with your doctor for the best advice. I appreciate we don’t all have the access we need at the moment and sometimes a quick fix or stopgap is helpful. For the same reason, although I try to avoid it, these are all links to Amazon. They have a huge range of wrist supports, and a decent return and refund system.
My original splint (Praxis)
My doctor gave me this splint when I first said I was having problems clenching my fist overnight. The strap around the wrist and arm is fully adjustable as it can attach to anywhere on the neoprene and provides enough support to stop my wrist from subluxing. It’s easy to line up and put on one-handed because of the way the big strap wraps around. The neoprene gives some additional warmth which I find nice except for on very hot nights. This splint comes quite high up over the palm of the hand so the design and the metal bar inside really stop the wrist from being able to flex.
I love this splint and find that it works really well and is very comfortable. The only downside is that attaching the Velcro to the neoprene causes it to fuzz and become less sticky over time. I think the lifespan of this splint if you wear it every night is probably around six months before the Velcro stops working. You can sew Velcro on top of the neoprene to increase the lifespan which I did but after about 12 months it’s really frayed and stretched beyond repair.
Splint #2 (Praxis, £5.99)
I bought this splint as a replacement for my worn out one. It’s the same brand, but a slightly altered design. They’ve changed the type of velcro on the wrist wrapping part, maybe to try to avoid the neoprene fuzzing. I’m not sure if it’s an improvement as I found this made it less sticky at the edges.
It’s one size fits all; I have small hands and wrists and find it comfortable and supportive enough. It restricts wrist movement curling the hand towards the wrist best, but doesn’t totally restrict wrist movement side to side.
Splint #3 (Actesso, £9.85)
I was looking for something that would be more breathable and cooler to wear in the summer. The design of this splint is quite a common one with panels of stretchy, breathable fabric at the sides. It’s quite difficult to put this splint on because has multiple straps and it’s tricky to hold the splint closed and line them all up. I chose this splint specifically because it looked the most breathable, but unfortunately because it has both elastic and thin parts, it doesn’t prevent my wrist from bending very much.
Splint #4 (BodyTec, £6.49)
This splint has a similar design to the one above but is made of neoprene. Again, from the side view it can be seen that the fabric of the splint doesn’t actually overlap itself. This does cut down on bulkiness but if you’re looking for a sturdy wrist support, it might be too stretchy. It was still possible for me to flex my hand inwards and sublux my wrist so I found this splint too flimsy and didn’t brace my hand well enough.
Splint #5 (Zofore, £13.97 but currently unavailable*)
If splints are like a prison for your wrist, this splint is Alcatraz. It’s very well made and sturdy, and the design ensures that skin doesn’t get trapped in the join. The straps are not stretchy and the middle strap wraps all the way around the arm and back on itself, making this splint the most supportive that I tried. It’s possible to tighten the straps so that you have no flexion in the wrist at all. I ordered the smallest size but the top strap is still a little long, so has to be positioned at an angle. Overall the fit is fine for my wrist and arm though. It is made of breathable fabric but now it’s cooler I haven’t noticed whether it’s effective.
The ‘strengths’ (literally) of the splint are also its weaknesses. Three straps are quite difficult to coordinate with one hand, especially the long middle one which sticks to everything when I’m trying to put it on. The first few times it was difficult to find the correct fit and not over tighten it, which led to me cutting off my circulation in my sleep, because it’s not so stretchy.
* Correct October 29th 2020
Wrist support (Dr Arthritis, £12.95)
Not a splint, but I sometimes use this wrap-around neoprene wrist support during the day. Although not as supportive, I find it useful if my wrist is feeling very weak and I have to do something where I need wrist flexibility like yoga or moving heavy things around. The neoprene strap that wraps all round the wrist gives the extra support I need to stop my wrist subluxing. Again because it’s neoprene it showing signs of wear, but I’ll probably replace it with the same kind because it is very comfortable.
I can’t speak for how well these splints will help for other wrist conditions like arthritis or carpal tunnel syndrome- you may find that you don’t need as much support or restriction of movement, or prefer to wear something less bulky. Several of the product pages state that they are used by the NHS although I’m not sure how you’d check that.
For preventing wrist clunching and subluxation at night, my top recommendation would be the Praxis splint, as I find it the easiest to put on and the most comfortable. Its only downsides are that it wears out relatively quickly (this may have been improved by the new design) and it can be hot to wear. The black Zofore splint was the sturdiest splint that I tried and was very supportive. I did find it difficult to get the fit right and coordinate the straps at first but have got the hang of it after a couple of weeks. I’d recommend putting a new splint on an hour or so before going to bed to get the fit right and avoid overtightening.
Tips for choosing a wrist splint:
- Fewer straps will make it easier to put on
- A strap that wraps all the way around the wrist will give better support
- Stretchy and breathable materials might not provide enough support
- Neoprene is a comfortable and warm material, maybe too warm
- Doctors may advise against wearing splints in the day to avoid deconditioning muscle. Always speak to a doctor for the best advice