From the Guidelines
A neutral wrist splint is the primary type used for carpal tunnel syndrome, as it minimizes pressure on the median nerve by keeping the wrist in a neutral position. This recommendation is based on the most recent and highest quality evidence available, which suggests that wrist splinting is an effective non-surgical treatment for carpal tunnel syndrome, although surgery may be more effective in most outcome measures 1. The use of a neutral wrist splint can help reduce inflammation, numbness, tingling, and pain associated with carpal tunnel syndrome.
Some key considerations for the use of wrist splints in carpal tunnel syndrome include:
- Wearing the splint at night during sleep to prevent unconscious wrist flexion
- Using a splint that is comfortable but snug, with rigid support on the palm side of the wrist
- Considering custom-made splints in certain cases where prefabricated splints are not suitable
- Consistently wearing the splint for at least 3-4 weeks, and potentially continuing nighttime splinting for several months or longer for symptom management
It is essential to note that while the evidence from the study 1 comparing surgical and non-surgical treatments for carpal tunnel syndrome is of very low to low quality, the findings suggest that surgery may have additional benefits over non-surgical treatments like wrist splinting. However, the use of a neutral wrist splint remains a recommended initial treatment approach for carpal tunnel syndrome, given its non-invasive nature and potential to provide symptom relief.
From the Research
Type of Splint Used for Carpal Tunnel Syndrome
- The type of splint used for carpal tunnel syndrome is typically a neutral wrist splint, which immobilizes the wrist in a neutral position or slightly extended at 0-15 degrees 2.
- A splint that immobilizes the wrist and the 2-5 metacarpophalangeal joints is recommended for patients with positive Berger test results 2.
- There are no statistically significant differences in the treatment results between individual and traditional orthoses, or between rigid and soft orthoses 2.
- Neutral wrist nocturnal splinting is effective in at least the short term for CTS patients, with significant improvements in symptom severity and functional status 3.
- The optimal duration of splinting is unclear, but one study found that 6 weeks of neutral wrist splinting resulted in better clinical improvements in patients with untreated mild and mild to moderate CTS, with no additional benefit in extending splinting for 6 additional weeks 4.