Hand therapists frequently need to modify orthoses to relieve pressure of an edge or pressure from an underlying bony prominence. Many therapists add padding. This discussion of a few basic principles may be of value to less experienced clinicians.
As clinicians, we all struggle with what to do when the patient’s response is not logical. The work of Adriaan Louw and his approach for all patients who have pain—therapeutic neuroscience education (PNE)—may be a useful alternative.