Night-time immobilization of the distal interphalangeal joint reduces pain and extension deformity in hand osteoarthritis

Rheumatology (Oxford). 2014 Jun;53(6):1142-9. doi: 10.1093/rheumatology/ket455. Epub 2014 Feb 8.


Objective: DIP joint OA is common but has few cost-effective, evidence-based interventions. Pain and deformity [radial or ulnar deviation of the joint or loss of full extension (extension lag)] frequently lead to functional and cosmetic issues. We investigated whether splinting the DIP joint would improve pain, function and deformity.

Methods: A prospective, radiologist-blinded, non-randomized, internally controlled trial of custom splinting of the DIP joint was carried out. Twenty-six subjects with painful, deforming DIP joint hand OA gave written, informed consent. One intervention joint and one control joint were nominated. A custom gutter splint was worn nightly for 3 months on the intervention joint, with clinical and radiological assessment at baseline, 3 and 6 months. Differences in the change were compared by the Wilcoxon signed rank test.

Results: The median average pain at baseline was similar in the intervention (6/10) and control joints (5/10). Average pain (primary outcome measure) and worst pain in the intervention joint were significantly lower at 3 months compared with baseline (P = 0.002, P = 0.02). Differences between intervention and control joint average pain reached significance at 6 months (P = 0.049). Extension lag deformity was significantly improved in intervention joints at 3 months and in splinted joints compared with matched contralateral joints (P = 0.016).

Conclusion: Short-term night-time DIP joint splinting is a safe, simple treatment modality that reduces DIP joint pain and improves extension of the digit, and does not appear to give rise to non-compliance, increased stiffness or joint restriction.

Trial registration: clinical,, NCT01249391.

Keywords: distal; interphalangeal; non-pharmacological therapy; osteoarthritis; pain; splint.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Finger Joint / physiopathology*
  • Hand Deformities, Acquired / etiology
  • Hand Deformities, Acquired / prevention & control*
  • Humans
  • Immobilization / methods*
  • Male
  • Middle Aged
  • Osteoarthritis / complications
  • Osteoarthritis / physiopathology
  • Osteoarthritis / therapy*
  • Pain / etiology
  • Pain / prevention & control*
  • Pain Measurement / methods
  • Patient Satisfaction
  • Range of Motion, Articular
  • Severity of Illness Index
  • Single-Blind Method
  • Splints
  • Treatment Outcome

Associated data