Investigating the Effectiveness of Full-Time Wrist Splinting and Education in the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial

Abstract

This study investigated the effects of wearing a wrist support splint for 8 wk and receiving a formal education program on patients with carpal tunnel syndrome (CTS), as well as factors associated with patients' desire to seek surgical intervention. Participants were recruited from a hospital surgical wait list and randomly assigned to an intervention group (n = 30) or a control group (n = 24). Significant improvements in measures of symptom severity and functional status over the duration of the study appeared in the intervention group but not in the control group. Logistic regression for the intervention group showed that symptom severity (odds ratio [OR] = 1.53, 95% confidence interval [CI] [1.20-1.93]), functional deficits (OR = 1.31, 95% CI [1.08-1.57]), pain score (OR = 1.25, 95% CI [1.11-1.61]), and symptom duration (OR = 1.11, 95% CI [1.01-1.24]) were positively associated with the desire to seek surgical intervention. This conservative CTS treatment program conducted by occupational therapists can improve symptoms and hand function in CTS patients.

Conservative therapeutic management of carpal tunnel syndrome

“…However, previous reviews have shown moderate evidence supporting the use of wrist splints in the treatment of CTS 11,30 . Furthermore, as noted by Roll and Hardison, a randomized and controlled trial was not included in any of these reviews 36,37 . A trial by Hall et al showed that the use of a wrist splint improved symptoms in CTS patients 37 .…”

“…Furthermore, as noted by Roll and Hardison, a randomized and controlled trial was not included in any of these reviews 36,37 . A trial by Hall et al showed that the use of a wrist splint improved symptoms in CTS patients 37 . There was no support for the long-term use of wrist splints in a review by Page et al 38 .…”

What about steroids?

“…The authors based their recommendation on a small randomizedcontrolled trial comparing wrist splints and an educational program and a control group who received nothing. 2 Perhaps not surprisingly, the control group experienced a dropout rate of over 22% compared to 3% in the treatment group. This obviously places the internal (and therefore external) validity in question.…”

“…[1][2][3][4][5] Lowquality studies do not adequately assess sodium intake, they use extreme variation in dietary sodium and they measure outcomes over a duration of a few days. They do not address known confounding factors for the outcomes being tested nor do they control for blood pressure (the main mechanism of sodium-induced harm) and they are conducted in populations with diseases where reverse causality is likely.…”

“…The publication of such studies, leveraged by the private sector, has created a false aura of scientific controversy around dietary salt. [1][2][3][4][5] Although the call for a large randomized controlled trial on dietary sodium is not new, it has limited feasibility in Western countries where the food supply contains so much sodium. 6 In Africa, where some populations still have low sodium intake, it was deemed unethical to increase dietary sodium in a trial setting.…”