Neutral wrist splint for mild to moderate carpal tunnel syndrome

Abstract

Background : Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Neutral wrist splint has been recommended for mild to moderate symptoms CTS. There is insufficient evidence regarding the effectiveness of splinting in longer periods of time (at least 3 months).

Objective : To evaluate the effects of 3 months neutral wrist splint on neurophysiologic condition, symptoms and functions for mild to moderate carpal tunnel syndrome (CTS).

Methods : Fifty-four patients with clinical symptoms, nerve conduction study (NCS), and diagnosed as mild to moderate CTS. During the 3-month duration of the study, the treatment group received day and night time, neutral wrist splints combined with condition-related patient instructions and the control group received only condition-related patient instructions. Neurophysiologic condition was evaluated by nerve conduction study
including distal sensory latency (DSL) and distal motor latency (DML). Symptoms and functional status were assessed by Boston Carpal Tunnel Questionnaire (SYMPT BCTQ and FUNCT BCTQ).

Results : The treatment group demonstrated improvement in all measured outcomes (DSL, DML, SYMPT BCTQ, and FUNCT BCTQ). The treatment group also showed significantly more improvement than the control group in decreasing DSL and DML values. In linear regression analysis, the decrease in DSL was significantly associated with splint treatment (RR = 4.79, 95% CI = 1.35 - 17.11; P = 0.02).

Conclusions : Three-month daytime and nighttime neutral wrist splinting was more effective than patient instructions alone in improving neurophysiologic condition in mild to moderate CTS. This splinting modality shows good patient compliance and no serious side effects.