From the Research
The treatment for a patient with pain along the median nerve distribution and a positive Tinel's sign, which suggests carpal tunnel syndrome, includes casting the hand in a neutral wrist position, but recent evidence suggests that a neutral wrist splint may be more effective than an extension splint 1. When immobilizing the wrist for carpal tunnel syndrome, the wrist should be placed in a position that minimizes pressure within the carpal tunnel by creating the optimal space for the median nerve and surrounding structures.
- Casting in extension (option C) reduces compression on the median nerve, but it may not be the most effective position according to the latest study 1.
- Palmar flexion (option B) would actually increase pressure within the carpal tunnel and potentially worsen symptoms.
- Adduction (option D) does not address the primary issue of nerve compression in the carpal tunnel.
- Dorsiflexion (option A) is another term for extension, but the most recent study 1 suggests that a neutral wrist position may be more beneficial. The splint or cast should be worn primarily at night but can also be used during the day for activities that exacerbate symptoms, typically for 2-6 weeks to see if symptoms improve before considering more invasive treatments 2, 1.