Hi I’m Dr. Matti Palo and I am a board certified orthopedic surgeon and I just wanna take a moment to discuss treatment options for Carpal Tunnel Syndrome and in particular splinting The American academy of Orthopedic Surgeons recommends either a local cortisone shot or a trial of wrist splinting before considering surgical intervention now what’s a trial a trial is at least three weeks Of wearing a wrists splint that keeps ideally the wrist in the neutral position So I want to talk about some of the options available out there.
For wrist splinting now this is a overthecounter brace and it has what we call a Palmer spar now this is designed to keep the wrist in a slightly extended position and there’s really only two it’s a good splint really only two problems with it One is the spar is on the palm side so if your actually trying to wear this at work or during activities of daily living it’s a little bit difficult because this spar can get in the way particularly with typing or anything that requires gripping which unfortunately a lot of daytime.
Activities do require gripping so that’s the only problem with this other than that it’s a good brace and the spar is a little bit malleable A little more malleable than I would like It is a plastic spar so you’re not able to actually bend it into a I straight position which is the neutral position the ideal position we want the wrist is in neutral like this and so when we have the wrist cocked up were actually can exacerbate the symptoms of carpal tunnel syndrome now the problem with the neutral position and one of the reasons why.
Carpal Tunnel Syndrome, Splinting Options
Every splint out there is not in the neutral position is because it’s not as efficient to grip with the hand in the neutral position we actually grip better with our hand back and you can actually test this By grabbing something you will notice if you keep your wrist back you have a lot more strength so sometimes you might have to take the brace off or loosen a brace in order to generate a grip strength you might need so again two things with this brace the spars on the.
On the bottom on the palm side which can get in the way and it actually keeps the wrist in a slightly extended position so it’s not ideal for carpal tunnel syndrome but it’s better than nothing certainly now another common brace configuration is having a spar on the bottom the top or the sides this is actually a a brace for men you can tell by the camouflage and again this spar is in the way When your wearing it and the wrist is in The slightly extended position so this is neutral position this is an extended position.
We want some wrist in a neutral position ideally again it’s a good brace a firm spar again it’s a plastic spar so you can’t really bend this to the proper position but better than nothing and it certainly will probably help with your symptoms now let’s look at a night brace so this example of a night brace so this is actually designed to keep your wrist immobilized why you sleep its designed to be worn on either the left or the right hand now let’s talk about this brace for a second becasue I actually think this is.
Not a bad option it actually keeps the MCP joints out into extension which is important because one of the problems that you have with Carpal Tunnel are the small muscles called the lumbricals which can ride up into the canal up to an inch when the rest is flexed so this actually keeps these out the Problem is it’s hot this is something that have to sleep in and obviously you Can’t wear this during the day It has a palmer spar which is okay For a night splint and keeps fingers in the right position but it’s hot.