Bracing and Splinting for Chronic Pain

Learn more about how braces and splints can be used to treat conditions associated with chronic pain. 

Braces and splints come in many shapes and sizes. Although they're generally used for acute injuries—keeping a sprained neck, knee or twisted ankle stable, for example—braces and splints can also be used as a treatment option to control chronic pain.

What Braces and Splints Do

There are three primary main goals of bracing and splinting:

  • to stabilize weak or injured joints
  • to prevent pain and inflammation from getting worse by limiting motion
  • to provide a measured and gradual force to a joint that is stiff (ankylosed) or contracted due to scar tissue (arthrofibrosis).

The latter form of splinting is referred to as "dynamic splinting" and uses a dynasplint or orthosplint. While other applications are static in nature,  dynamic splinting not only stabilizes a joint but also helps to provide a greater active range of motion (ROM) to that joint via dynamic tension. Secondary goals by a therapist or clinician aimed at facilitating healing, avoiding further irritation/injury, and unloading a joint may involve unloading braces, such as for osteoarthritis of the knee.

A neck brace may be soft or rigid to help stabilize and relieve pain. (Source: 123RF)

Types of Chronic Pain that Bracing or Splinting Can Help

Because they offer multipurpose treatments, braces and splints may be beneficial in treating numerous conditions associated with pain. For instance:

  • Carpal tunnel syndrome: The goal is to immobilize the wrist and prevent it from excessive wrist flexion to avoid “pinching” or compressing the median nerve. Wrist splints can help with the pain, tingling, and numbness associated with carpal tunnel syndrome because they prevent your wrist from staying bent in positions that irritate the nerve, especially while you're sleeping. More on carpal tunnel.
  • Low back pain: There are two different kinds of braces that may be used for low back pain: soft vs rigid braces. Soft braces work by increasing pneumatic mechanism in the abdominal core, providing rigidity internally, and supporting the spine in this manner. A rigid brace stays or bolsters to give the brace rigidity. Braces may be useful for various spine conditions that cause low back pain: Spinal braces are sometimes used to stabilize your lumbar spine (low back), and can provide support and comfort for a wide variety of back injuries. More on low back pain.

  • Muscle strains or sprains: Elbow, knee, ankle, and foot braces are commonly used for ligament and tendon strains or sprains. The general consensus, according to Tiziano Marovino, DPT, MPH, DIAPM, and a member of PPM's Editorial Advisory Board, is that in a grade 1 or 2 sprain, no external stabilization is needed, but in a 2+ to 3 or more, it might benefit from bracing.

  • Neck pain: There are two types of braces used here as well: soft vs rigid collars. The soft brace can be used for whiplash type injuries for 2 to 4 weeks after a motor vehicle accident, for example. Rigid braces are more supportive and provide dynamic tensions that is aimed at mechanically changing the neck to thoracic spine orientation (ie reverse forward head postures). As with low back pain, braces, such as cervical collars, may be useful for certain spine conditions that cause neck pain: neck injuries (eg, whiplash). Collars are used frequently after neck surgery. Neck braces can be used to keep your cervical spine (neck) stable. More on neck pain.
  • Osteoarthritis: A knee unloader brace is a common type of brace used for treating osteoarthritis of the knee. It works by taking pressure off the side of the joint that has arthritis. Referred to as a uni-compartmental brace, it is used to “unload” the painful compartment—usually the medial side.
  • Rheumatoid arthritis: If you have hand or finger pain caused by rheumatoid arthritis, special braces can relieve pain and inflammation by supporting joints weakened by this destructive type of arthritis. More on rheumatoid arthritis pain.
  • Spinal cord injury: Spinal bracing can be used to stabilize the structures supporting your spine, such as muscles and ligaments.

Materials and Feel of a Brace or Splint

A brace or splint works best when it's customized—they're not as effective if they don't fit properly. The brace or splint should be comfortable, especially since you may need to wear it at night or perhaps all day. Nightsplints are used typically for carpal tunnel syndrome and plantar fasciitis problems. The splint maintains a certain set position in both cases for the entirety of the sleep duration hoping to structurally alter the collagen tissue in both cases—one in the carpal ligament, the second in the plantar fascia.

Your doctor can refer you to a licensed orthotist who will customize a brace or splint for you by determining the right fit, type, and material. Most braces and splints are made of neoprene, metal, and other materials. You may find that one material is more comfortable than the others.

Side Effects of Braces and Splints

Fortunately, there are very few side effects for bracing and splinting for chronic pain. The most serious problem is developing arthrofibrosis (ie, scar tissue complicates an injury or trauma) secondary to prolonged and excessive immobilization of a joint. For certain conditions, such as osteoarthritis and rheumatoid arthritis, excessive use of braces or splints can actually lead to stiff joints or weak muscles: Your body may get used to the support of the brace or splint. Superficial skin irritation is another common side effect of frequent brace wearing.

For the brace or splint to be effective, you'll need to follow your doctor's instructions carefully about how to wear it and for how long. Also, keep in mind that bracing and splinting are only one part of your treatment plan. To manage a chronic pain condition, you may also need to take medications and attend regular physical therapy sessions, for example.

-Dr. Marvino reviewed and updated this treatment center in Spring 2019.

Updated on: 04/05/19
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