FRIDAY, Jan. 7 (HealthDayNews) -- A simple treatment -- splinting your wrists
at night -- may be all that's needed to improve the numbness and tingling of
early carpal tunnel syndrome.
That's the conclusion of a new study from the January issue of the
Archives of Physical Medicine and Rehabilitation , which found that
wearing a custom-made wrist splint for six weeks could bring long-lasting
relief.
"This fairly innocuous, low-cost intervention dramatically improves the level
of discomfort, not only in the short-term, but the relief lasts up to a year
out," said study author Dr. Robert Werner, the chief of physical medicine and
rehabilitation at the Ann Arbor VA Medical Center in Michigan.
Carpal tunnel syndrome is a repetitive stress injury that occurs when the
median nerve in the wrist is compressed for long periods of time. This
compression can cause permanent nerve damage if left untreated. According to the
National Institutes of Health, carpal tunnel syndrome is five times more common
in women than in men and most often occurs in people between the ages of 30 and
60.
Conservative treatment options include wrist splints, rest, non-steroidal
anti-inflammatory medications (NSAIDs), diuretics, cold laser, vitamin B6 and
steroid injections, according to the study.
"Simple treatments like nighttime splits can be useful when you get at it
early, but many people don't seek treatment right away, and light carpal tunnel
can go for long periods of time, causing permanent nerve injury," said Peter
Stevens, a physician's assistant in the orthopedics department at Ochsner Clinic
Foundation Hospital in New Orleans.
If simple treatments fail, surgery becomes an option. Werner said that about
half the people with carpal tunnel syndrome end up having surgery, which is
successful for most. But, he added, surgery is expensive and means a month or so
of lost work and discomfort.
One hundred and twelve people working at a Midwestern automotive plant were
recruited for the study. The repetitive nature of their work puts auto workers
at an increased risk of carpal tunnel syndrome, the researchers said. All of the
study participants had early symptoms of the syndrome, including burning,
tingling, numbness, and pain in the hand that lasted longer than a week and
happened more than three times in the six months before the study.
All of the participants watched a short video about carpal tunnel syndrome
that contained tips on reducing the risk of the disorder.
Then, 63 people were fitted with custom-made wrist splints that held their
wrist in a neutral position, which meant the median nerve wasn't compressed at
all. They were told to wear the splints every night for six weeks. The other 49
received no additional instruction.
After 30 days, the group wearing the splints had almost a 50 percent
reduction in symptom severity; the control group had a 15 percent reduction.
The researchers followed up with the study participants again after a year,
and many who had used the splints still had improvement in their symptoms.
"This study clearly indicates that if you do nighttime splinting that the
discomfort levels are improved," said Werner, who suggested that people can try
this at home. He said the splints are available at drugstores and they're a
"simple home remedy."
But, he added, if you don't start feeling relief after six weeks, or your
symptoms are getting worse, you should seek medical attention.
Werner said that wearing the splints kept the study participants from
compressing the median nerve at night because people often sleep with their
wrists in strange positions. The splints also allowed the median nerve to rest
and begin to repair overnight, he said.
"Early intervention is key," said Heather Turkopp, an occupational therapist
and certified hand therapist at William Beaumont Hospital in Royal Oak, Mich.
"The longer that nerve is compressed, the more permanent damage you're doing."
She said symptoms to be on the watch for include numbness and tingling in the
median nerve area, which includes the thumb, index and middle finger, and
sometimes part of the ring finger.
Stevens pointed out the symptoms are often worse at night, and when the wrist
is bent, such as holding a book or the telephone.
If you buy splints on your own, Turkopp pointed out that you should make sure
the wrist isn't flexed at all. Sometimes, she said, you have to bend the metal
support to ensure that the wrist is in a neutral position.
The study was funded by the United Auto Workers-General Motors National Joint
Committee on Health and Safety.
SOURCES: Robert Werner, M.D., professor, department of physical medicine and
rehabilitation, University of Michigan Health System, and chief, physical
medicine and rehabilitation, Ann Arbor VA Medical Center, Ann Arbor, Mich.,
Peter Stevens, certified physician's assistant, department of orthopedics,
Ochsner Clinic Foundation Hospital, New Orleans; Heather Turkopp, occupational
therapist and certified hand therapist, William Beaumont Hospital, Royal Oak,
Mich.; January 2005 Archives of Physical Medicine and Rehabilitation