Wrist splints and hand exercises
Many people who have carpal tunnel syndrome have mild or moderate symptoms that come and go. In those cases, wearing a splint and avoiding too much stress on the joint may be enough to provide relief.
The main symptoms of carpal tunnel syndrome are tingling, numbness or pain in parts of the hand. Sometimes it's difficult to move your thumb or first two fingers properly too. This is caused by too much pressure on the median nerve, which runs through the carpal tunnel in the wrist.
Sometimes these symptoms disappear again without treatment. A wrist splint can be worn for support. Splints don't always offer enough relief from symptoms, but have hardly any side effects compared with other treatment options, like corticosteroid therapy or surgery.
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 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.
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?
Overstretching or overusing your wrist 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 work around the home or on an assembly line, or when using machinery that creates strong vibrations, 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 improve blood circulation in the hands. There are a number of different kinds of hand exercises. Massages, yoga and exercises designed to mobilize the nerve are also sometimes recommended, as are chiropractic and osteopathic therapies. Unfortunately there's not much good-quality research on these kinds of treatments, so it's difficult to tell whether they do more good than harm.
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Huisstede BM, Randsdorp MS, Coert JH, Glerum S, van Middelkoop M, Koes BW. Carpal tunnel syndrome. Part II: effectiveness of surgical treatments - a systematic review. Arch Phys Med Rehabil 2010; 91(7): 1005-1024.
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.
Page MJ, Massy-Westropp N, O'Connor D, Pitt V. Splinting for carpal tunnel syndrome. Cochrane Database Syst Rev 2012; (7): CD010003.
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