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Dear Dr. Roach: I have symptoms of carpal tunnel syndrome. I read that a hand brace can help with this. Does it really work? Does anything else (besides rest)? -- K.R.
Dr. Roach: The carpal tunnel is an anatomic space inside the wrist. The median nerve runs through this space, and provides sensation to the thumb, index finger, middle finger and half of the ring finger. In carpal tunnel syndrome, the nerve is compressed. This can happen during pregnancy, with thyroid disease and with overuse, especially high trauma cases, such as in a jackhammer operator. Many times there are no particular risk factors.
The symptoms of carpal tunnel syndrome include pain and numbness in the affected fingers. Sometimes the sensations feel like they are going up the hand, but do not usually rise above the elbow. If symptoms progress to the point of weakness, then it's time to visit the hand surgeon in order to avoid permanent weakness and atrophy of the hand muscles.
For people with numbness or tingling but not weakness, there are several treatments, some of which can be effective for a given person. If there is a medical cause, such as thyroid disease, treatment of the underlying issue can make carpal tunnel syndrome go away. For those who are overusing the hand and wrist, reducing activity can make a big difference. Anti-inflammatories are modestly helpful at best, but yoga was shown to be effective. Injection of steroids is helpful, but it last only a few months in most people. A brace that keeps the wrist in a neutral position (straight, not bent up or down), especially at nighttime, is effective in some people, and may delay or eliminate the need for surgery. Some people wear the braces continuously.