Splints Work for Carpal Tunnel Syndrome, Study Shows
April 24, 2000 -- Wrist splints really can help people with carpal tunnel
syndrome, even those with severe symptoms, new research has shown.
Carpal tunnel syndrome (CTS) is caused by compression of a nerve that runs
through the carpal tunnel in the wrist and is thought to be caused by
repetitive motions, such as typing. People with the syndrome typically
experience pain, weakness, and numbness or tingling in the hand and arm. Those
who seek treatment can get a recommendation of anti-inflammatory drugs,
occupational therapy, surgery, or wrist splints, depending on the health
professional they see.
The new study, reported in the Archives of Physical Medicine and
Rehabilitation, clears up some of the confusion, at least as far are wrist
splints are concerned. There have been few previous studies that scientifically
measured the benefits of wrist splints and tried to determine which kinds of
splints should be worn and for how long.
For the study, William C. Walker, MD, from the Medical College of Virginia,
and colleagues assigned 17 people with CTS to either full-time or night-only
splint use for six weeks. Both before and after this period, the participants
answered a series of questions about how severe their symptoms were and how
well they were able to function. They also underwent before-and-after
electrodiagnostic testing, in which delicate machinery is used to measure the
speed with which nerves sense and respond to stimulation.
Wearing the splints either at night only or all the time brought significant
improvement after the six-weeks, with full-time splint wearers faring slightly
better. Symptoms improved, functions were gained, and nerves began to work a
"The splinting intervention is already a frequently used strategy in
treatment, and this study will provide even greater justification ... for use
of wrist splinting," says Brian J. Dudgeon, PhD, OTR, who reviewed the
article for WebMD. Dudgeon is an occupational therapist and lecturer in the
department of rehabilitation medicine at the University of Washington School of
Medicine, where he specializes in carpal tunnel syndrome.
In a surprising finding, patients in this study with severe CTS experienced
improvements that were similar to or greater than those with mild to moderate
CTS. As Dudgeon tells WebMD, "The currently accepted therapy for CTS is
dependent on its severity." Mild to moderate symptoms are often treated
more conservatively, with splints, while severe symptoms are typically treated
with surgery. But, according to Walker, "these findings support the use of
splints in severe CTS."
While splint use may be beneficial, some patients in the study had a hard
time following their splint schedules. Most who were supposed to wear splints
full time admitted to taking breaks during the day, sometimes leaving them off
for more than half the day. Despite the difficulty of constant splint wearing,
Walker and his team still recommend continuous wear.
Participants in both treatment groups wore rigid, custom-molded,
thermoplastic wrist splints. The choice of splints -- both in material and
position -- is essential, Dudgeon says. Many commercial and even some
custom-made splints fail to hold the wrists in a neutral position. Neutral
positions are thought to minimize carpal tunnel pressure, minimize pain, and
- People with carpal tunnel syndrome saw measurable improvement of symptoms
and gained function after six weeks of wrist-splint therapy.
- A full-time splint schedule provided more dramatic improvements, suggesting
patients should strive to wear their splints as often as possible.
- Patients with both severe and mild-to-moderate carpal tunnel syndrome
benefited from wearing wrist splints.