Carpal Tunnel Syndrome

CTS (Carpal Tunnel Syndrome) usually occurs in females between the ages of 30-60 years old, probability of 2 to 5 times higher than male. Main symptom is hand paralysis and pain causes the activity inconvenience. This symptom may be extended to elbow and shoulder. Most patients will waking up because of paralysis and pain in hand during sleep. The generally conservative treatment including wear a wrist splint, taking NSAIDs (Nonsteroid Anti-inflammatory Drugs) and the affected part steroid injection. If conservative treatment fails or thenar muscle atrophy will propose the surgery treatment.

Korthals-de Bos IB,et al. research suggested surgery and wear a wrist splint after twelve months and the probability of success and cost is similar. The surgery is 92% of success rate, wear a wrist splint is 72% of success rate. Gerritsen AA,et al. research suggested wear a wrist splint and treat the chance that CTS slight patient recovers is very high in one year. C-M Chen research suggested CTS patients wear a wrist splint therapy the pain and finger strength of the affected part perceptible improvement after two to four weeks. O. Baysal research suggested CTS patients are wearing wrist splint immediate improvement in pain for the affected part. Every night, patients wear a wrist splint after eight weeks for the pain of the affected part; grip strength and finger force has perceptible improvement.

C-L Chen,et al. research suggested patients is wearing wrist splint will affect the work difficulty of the affected part using the tool. So, need wrist force and manipulation tools is to wear a wrist splint willingness main reason. Premoselli,et al. research suggested CTS patient wear a wrist splint treatment only at night, improvement at symptom and improvement the nerve, still keep having result of treatment after six months. C-M Chen research suggested CTS patient wears wrist splint for more than eight hours every day, lasts two to four weeks, symptom and finger force all have perceptible improvement. Phalen research suggested hand and wrist would often keep flexed-wrist while sleeping. Wrist vein blood retention produce local swelling, pain caused by nerve compression within the carpal tunnel. So patients wear a night splint to maintain the natural position of the wrist, can improvement symptoms.

(1) Eversmann WW. Entrapment and compression neuropathies. In: Green DP, editor. Operative Hand Surgery. 2nd ed. New York: Churchill Livingstone; 1988. p.1430-40.

(2) Wright PE. Carpal tunnel and ulnar tunnel syndromes and stenosign tenosynovitis. In: Crenshaw AH, editor. Campbell’s Operative Orthopaedics. 8th ed. St Louis: Mosby Year Book; 1992. p.3435-8

(3) S-M Chen. Subjective and objective evaluation on the effect of splinting in short-term use for carpal tunnel syndrome: a preliminary study. Taiwan Journal of Physical Medicine and Rehabilitation, 2010;38: p19-25

(4) Korthals-de Bos IB, Gerritsen AA, van Tulder MW, et al. Surgery is more cost-effective than splinting for carpal tunnel syndrome in the Netherlands: results of an economic evaluation alongside a randomized controlled trial. BMC Musculoskeletal Disord 2006;7: p86-94

(5) Gerritsen AA, Korthals-de Bos IB, Loaboyrie PM, et al. Splinting for carpal tunnel syndrome: prognostic indicators of success. J Neurol Neurosurg Psychiatry 2003;74: p1342-4

(6) C-M Chen. Factors affecting therapeutic compliance in wearing a cock-up splint by patients with carpal tunnel syndrome. Cheng Ching Medical Journal 2011;7: 59-66

(7) O. Baysa. Comparison of three conservative treatment protocols in carpal tunnel syndrome. Blackwell Publishing 2006;60: p820-828

(8) Premoselli S, Sioli P, Grossi A, et al. Neutral wrist splinting in carpal tunnel syndrome: a 3- and 6- months clinical and neurophysiologic follow-up evaluation of night-only splint therapy. Eura Medicophys
2006;42:121- 6.
(9) Phalen GS. The carpal-tunnel syndrome. Clinical evaluation of 598 hands. Clin Orthop Relat Res 1972;83: 29-40.