(Note: For this discussion a splint also means a brace, but technically a splint immobilizes a joint while a brace supports a body part in the correct position.) Every patient who sees a carpal tunnel doctor invariably asks, "Should I use a splint?" What the patient really wants to know is if a splint will work to help improve their condition. So the first issue is to define the condition. If you indeed have carpal tunnel syndrome, wrist tendonitis or repetitive strain injury of the hand or wrist, splinting may or may not be right for you. WHAT A SPLINT SHOULD BE USED FOR In most circumstances splinting can be very useful for the natural healing process. That's because a splint's primary purpose is to rest the hand and wrist. It is not intended to take away pain and other symptoms. In fact, sometimes splints can be a barrier to healing and in some rare cases can even thwart healing. In general, almost every dysfunction of the wrist and hand will require you to first rest the joint. Rest is one of the body's first defenses against injury and disease. Your body often forces you to become immobile so its healing mechanisms can work unimpeded. When you're sick, in pain or injured you often feel tired because your body is driving itself to shut down (rest) in order to begin the healing process. But even with generous rest, it's not easy to function daily without using your hand. And actually, total immobilization of the hand can be harmful. Moving the wrist joint (a little, without stressing it) is important to facilitate blood flow, lymphatic drainage and to minimize the potential of adhesions within the tissues. Keeping the wrist joint stationary provides none of these benefits. NIGHT SPLINTING If you already have a hand or wrist dysfunction you should always wear a splint when you sleep. During sleep we unconsciously make a fist or bend our hands. This produces tremendous stressful forces on the wrist joint which is already trying to heal itself. So any healing progress you make while awake can be completely undone at night if you don't take precautions. Most people find that night splinting is uncomfortable at first. But like anything else you wear, the initial discomfort quickly vanishes and you won't even know you're wearing a splint. DAY SPLINTING During the day it's almost impossible for anybody to not move their hand or wrist. So if you're wearing a splint, an unconscious flinch against the immobile support can actually cause harm because you force your hand to produce an isometric maneuver. If there is no "give" to the splint, then your tissues work harder against it - and that's where the damage can happen. The forces which caused the initial damage are re-applied, and healing is thwarted. If you have carpal tunnel syndrome, wrist tendonitis or repetitive strain injury, you should wear a splint only sparingly during the day (only to rest and limit your hand movements). But most importantly, you should always wear a splint while sleeping. INCLUDE DEEP TISSUE CARPAL TUNNEL MASSAGE In addition to splinting, everybody with carpal tunnel syndrome, wrist tendonitis or repetitive strain injury should include deep tissue carpal tunnel massage in their daily regimen. It is nearly 100% effective in alleviating symptoms of carpal tunnel syndrome, wrist tendonitis and RSI. However, deep tissue carpal tunnel massage can only be performed by a qualified physical or massage therapist, but the Carpal Rx can perform this identical massage of your wrist and forearm automatically and at home. Called Carpal Rx Therapy, you're sure to get twice daily massages to get rid of your symptoms and keep them from coming back -- and at a fraction of the cost of actually visiting a human therapist. Learn more at www.CarpalRx.com REFERENCES 1. University of Michigan Health System, 2005 2. Walker WC, Metzler M, Cifu DX, Swartz Z. Neutral wrist splinting in carpal tunnel syndrome: a comparison of night-only versus full-time wear instructions. Arch Phys Med Rehabil. 2000 Apr;81(4):424-9. 3. Courts, RB. Splinting for symptoms of carpal tunnel syndrome during pregnancy. J Hand Ther. 1995 Jan-Mar;8(1):31-4. 4. Muller M, et. al. Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review. J Hand Ther. 2004 Apr-Jun; 17(2):210-28. 5. Sevim S, et. al. A. Long-term effectiveness of steroid injections and splinting in mild and moderate carpal tunnel syndrome. Neurol Sci. 2004 Jun;25(2):48-52. 6. R.A. Werner et al. Randomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome. Arch. Phys. Med. Rehabil. 2005;86:1-7.

• published: 01 Mar 2014
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