The use of orthoses in the treatment of carpal tunnel syndrome. A review of the literature from the last 10 years

Abstract

IntroductionA review of the literature from the last 10 years quite clearly shows that immobilization of the wrist in the splint (orthosis) is the most effective, initial method of conservative treatment of carpal tunnel syndrome (CTS). The particular advantages of the described method of treatment are: availability, low cost, good patient tolerance, simplicity and minimal incidence of complications. The aim of this study was to try to define the criteria of proceeding with the selection of the type of orthosis and the duration of its use depending on the clinical condition and the patient’s expectations.Material and MethodsThe PubMed electronic database was searched for appropriately selected studies published between 2012 and 2022. The search strategy used was based on the following keywords: carpal tunnel syndrome, immobilization, orthosis, conservative treatment. The authors also searched the cited literature on relevant research and review papers on potentially relevant topics related to conservative treatment of the CTS.ConclusionsImmobilization in an orthosis gives therapeutic effects in all patients, regardless of the stage of the carpal tunnel syndrome. Most often the orthosis is only used at night for several weeks. During the exacerbation of symptoms, it can also be used during the day during activities that increase symptoms. In practice, it is recommended to wear a splint that immobilizes the wrist in a neutral position or slightly extended at 0–15 degrees (most often 0–5 degrees). A splint immobilizing the wrist and the 2–5 metacarpophalangeal joints are recommended for patients with positive Berger test results. There are no statistically significant differences in the treatment results between individual and traditional orthoses. No statistically significant differences were observed in the treatment effects between rigid and soft orthoses.