When are wrist splints considered?

Many people with mild to moderate carpal tunnel syndrome wear a splint at night for a few weeks. The splint holds the wrist joint in a neutral position. The symptoms are worse at night because your hand is more likely to bend while you're sleeping. The splint prevents this from happening. It's also important to move the joint normally during the day to keep it from becoming stiff and stop the muscles becoming weak. A support bandage can be used instead of a splint.

Studies suggest that wearing a splint can improve the symptoms within a few weeks, but the effect is often only temporary. In some people splints don't help at all, or the symptoms return after a while.

Most people get used to wearing a splint and don't find that it stops them from sleeping. The skin might occasionally tingle a bit or feel swollen or numb when the splint is removed in the morning.

There are many different types of splints. According to research, none of them are more effective than the others. So there's nothing wrong with trying out a different type if you don't feel happy with the one you have.

Does avoiding certain types of strain help?

Overusing your wrist or putting abnormal stress on it can make the symptoms worse. Sometimes they become more severe when you do repetitive activities or put extreme strain on the joint – for instance, while doing manual labor, working on an assembly line, or using machinery that vibrates a lot, such as a jackhammer.

It's not always possible to avoid these kinds of activities for a while at work to see if symptoms then improve. You may need to stay home from work for some time. It's important to keep moving your wrist as you normally would, but to avoid putting too much strain on it. You can also wear a splint at night.

Research has shown that computer work has at most a very small effect on carpal tunnel syndrome. Ergonomic computer keyboards with an elevated and curved surface are still sometimes recommended to help prevent problems. They are designed to allow you to keep your hands in a more neutral position, reducing the strain on your hand and wrist when typing. There's hardly any research on whether this can help to prevent or relieve symptoms.

How effective are hand exercises?

Some experts think that hand exercises can reduce the pressure on the median nerve in the carpal tunnel and reduce the symptoms. Various types of special hand exercises are used to stretch and strengthen the hands. Massages, yoga and exercises designed to mobilize the nerve are also sometimes recommended, as are chiropractic and osteopathic treatments. So far, studies have not shown that moving the hand in these ways can help to relieve the symptoms.

Sources

• D'Angelo K, Sutton D, Cote P, Dion S, Wong JJ, Yu H et al. The effectiveness of passive physical modalities for the management of soft tissue injuries and neuropathies of the wrist and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration. J Manipulative Physiol Ther 2015; 38(7): 493-506. [PubMed: 26303967]
• Healy A, Farmer S, Pandyan A et al. A systematic review of randomised controlled trials assessing effectiveness of prosthetic and orthotic interventions. PLoS One 2018; 13(3): e0192094. [PMC free article: PMC5851539] [PubMed: 29538382]
• Huisstede BM, Hoogvliet P, Franke TP et al. Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials. Arch Phys Med Rehabil 2018; 99(8): 1623-1634. [PubMed: 28942118]
• O'Connor D, Page MJ, Marshall SC, Massy-Westropp N. Ergonomic positioning or equipment for treating carpal tunnel syndrome. Cochrane Database Syst Rev 2012; (1): CD009600. [PMC free article: PMC6486220] [PubMed: 22259003]
• Page MJ, Massy-Westropp N, O'Connor D, Pitt V. Splinting for carpal tunnel syndrome. Cochrane Database Syst Rev 2012; (7): CD010003. [PMC free article: PMC7389822] [PubMed: 22786532]

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