Should i sleep in my wrist brace

Many people who have carpal tunnel syndrome have mild or moderate symptoms that come and go. In those cases, wearing a splint and avoiding too much stress on the joint may be enough to provide relief.

The main symptoms of carpal tunnel syndrome are tingling, numbness or pain in parts of the hand. Sometimes it's difficult to move your thumb or first two fingers properly too. This is caused by too much pressure on the median nerve, which runs through the carpal tunnel in the wrist.

Sometimes these symptoms disappear again without treatment. A wrist splint can be worn for support. Splints don't always offer enough relief from symptoms, but have hardly any side effects compared with other treatment options, like corticosteroid therapy or surgery.

When are wrist splints considered?

Many people with mild to moderate carpal tunnel syndrome wear a splint at night for a few weeks. The splint holds the joint in a neutral position. The symptoms are worse at night because your hand is more likely to bend while you're sleeping. The splint prevents this from happening. It's also important to move the joint normally during the day to keep it from becoming stiff and stop the muscles becoming weak. A support bandage can be used instead of a splint.

Studies suggest that wearing a splint can improve the symptoms within a few weeks, but the effect is often only temporary. In some people splints don't help at all, or the symptoms return after a while.

Most people get used to wearing a splint and don't find that it keeps them from sleeping. The skin might occasionally tingle a bit or feel swollen or numb when the splint is removed in the morning.

There are many different types of splints. According to research, none of them are more effective than the others. So there's nothing wrong with trying out a different type if you don't feel happy with the one you have.

Does avoiding certain types of strain help?

Overstretching or overusing your wrist can make the symptoms worse. Sometimes they become more severe when you do repetitive activities or put extreme strain on the joint – for instance, while doing work around the home or on an assembly line, or when using machinery that creates strong vibrations, such as a jackhammer.

It's not always possible to avoid these kinds of activities for a while at work to see if symptoms then improve. You may need to stay home from work for some time. It's important to keep moving your wrist as you normally would, but to avoid putting too much strain on it. You can also wear a splint at night.

Research has shown that computer work has at most a very small effect on carpal tunnel syndrome. Ergonomic computer keyboards with an elevated and curved surface are still sometimes recommended to help prevent problems. They are designed to allow you to keep your hands in a more neutral position, reducing the strain on your hand and wrist when typing. There's hardly any research on whether this can help to prevent or relieve symptoms.

How effective are hand exercises?

Some experts think that hand exercises can reduce the pressure on the median nerve in the carpal tunnel and improve blood circulation in the hands. There are a number of different kinds of hand exercises. Massages, yoga and exercises designed to mobilize the nerve are also sometimes recommended, as are chiropractic and osteopathic therapies. Unfortunately there's not much good-quality research on these kinds of treatments, so it's difficult to tell whether they do more good than harm.

Sources

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Wrist splints are often used by people dealing with carpal tunnel syndrome (CTS), rheumatoid arthritis (RA), and various other causes of wrist pain, stiffness, or weakness. They come in many shapes, sizes, and materials, but fall into two basic categories: resting splints and working splints. You should consult a medical professional to determine the best splint type for you, get the splint custom-fitted if possible, wear it only as much as is recommended, and make sure you know how to properly wear it and care for it.

Things You Should Know

• For carpal tunnel syndrome or rheumatoid arthritis, wear your wrist splint to bed at night.
• If you use a working splint, take breaks from your splint, get it custom-fitted, and even if your wrist starts to feel better, keep wearing your splint.
• To avoid skin conditions or muscle weakness, inspect your skin for redness and pick up a few lightweight items each time you remove your splint.

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   Wear a resting splint only as advised by a medical professional. Resting splints are usually made of a rigid, molded plastic material and are meant to completely immobilize your wrist in a neutral position. Your splint should relieve pain and swelling by supporting your hand and wrist in a neutral position. Resting splints are intended for use while sleeping or at rest.[1] However, you should see a physician, physical therapist, or certified hand therapist to determine if this is necessary and appropriate.[2]

   • Under most circumstances, resting splints should be worn overnight while you sleep. Your doctor may recommend that you wear your splint sparingly during the day if you're experiencing flare-ups or have painful joints. Make sure you only wear it as recommended by your doctor.
   • If you wear one for too long or too frequently, your wrist joint will stiffen up and the supporting muscles will weaken due to you not using them.

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   Use a splint that is custom-fit to your wrist. Resting splints work best if the rigid material is molded to fit specifically over your unique wrist area. Your doctor, physical therapist, or another medical professional should be able to give you information on how and where to acquire a custom-fitted splint.[3]

   • Splints that fit poorly won’t provide the right support and often lead to skin irritation and joint discomfort.
   • Don’t wear a splint designed for someone else—it may do more harm than good.

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   Wear it nightly for at least a month to address CTS. If you have been diagnosed with carpal tunnel syndrome (CTS), your doctor’s first recommendation may be to wear a resting splint nightly for a month. Roughly one-third of CTS patients find that this treatment alone is enough to reduce their symptoms for at least a year.[4]

   • It’s much easier to bend your wrist awkwardly (in ways that constrict the carpal tunnel in your wrist) for long periods during the night. This is often the primary contributor to CTS, even if you might assume it’s mostly due to working at a keyboard every day.

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   Apply it nightly or during flare-ups to help manage RA. If you’re dealing with rheumatoid arthritis (RA), you may be advised to combine nightly use of a resting splint with daily use of a working splint during flare-ups.[5] Using only this combination for a month has been shown to reduce wrist pain in about one-third of RA sufferers.

   • Don’t wear a resting splint all night and a working splint all day unless specifically advised to do so by your doctor, and do it only for as long as advised. Otherwise, you may cause further joint stiffness and muscle weakness.
   • Always follow your doctor's or physical therapist's advice so that you heal well. This will help prevent muscle weakness.

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   Get your working splint custom-fitted if possible. Because working splints aren’t rigid and custom-molded like resting splints, it’s possible to find a model that fits and works fairly well either in stores or online. However, it’s still best to get the splint custom-fitted to your wrist by a medical professional if possible.

   • At least consider buying a splint in-person at a medical supply store with employees who are willing and able to help you find the best off-the-shelf model for your needs.
   • Some working splints have a flat metal insert that runs from the base of the palm up past the wrist. These can be bent by hand to fit the contours of your wrist more comfortably.
   • A working splint will stabilize the joints in your hands and wrists.

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   Don’t wear the splint all the time. Because they are made of various elastic materials that allow at least some freedom of wrist movement, working splints can easily be worn while doing most everyday activities. However, just as with resting splints, overuse of working splints can result in joint stiffness and muscle weakness over time, not to mention potential skin irritation.[6]

   • If your doctor advises you to wear it daily for a month, ask about whether and how often you should remove it to loosen up your wrist joints and work the muscles.
   • If you’re advised to wear it when doing activities that put strain on your wrist—yard work, moving furniture, etc.—only wear it during those times.

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   Don’t stop splinting immediately upon feeling better. People are often over-eager to ditch their working splints, either because their wrist pain has subsided, they don’t like the reduction in wrist flexibility, or they simply dislike the look of the brace (and the questions they get about it). However, if your doctor has advised you to wear it for a month, for example, keep using it for that long.[7]

   • Even if your wrist feels better, it still may be healing and susceptible to re-injury or re-aggravation.
   • Wrist splints do come in many styles and colors if aesthetics are important to you.

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   Consider getting two splints so you can switch them out. People sometimes stop wearing their wrist splints earlier than they should because they get dirty or begin to smell bad. While most splints can be surface-washed or possibly submerged and hand-washed, you may want to invest in 2 of them so you can rotate them when one needs cleaning.

   • If you get 2 working splints, it’s best to get the exact same model with the exact same fit. You might be able to find different colors to coordinate with your wardrobe, though!

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   Slide on the splint so it’s snug against your wrist and thumb. Whether it’s rigid or flexible, the inside of the splint should be snug against the base of your thumb, the base of your palm, and your wrist. Make sure you slide it up your lower arm until it makes contact with these areas.

   • This is one reason why custom fitting is a good idea. That way, you know the splint will fit well in all the major contact points.

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   Secure the Velcro straps from the splint’s top or bottom. For most rigid resting splints, it’s usually best to secure the top Velcro strap first (nearest the elbow), then work your way down. For flexible working splints, though, it may be best to start with the lowest (wrist-side) strap first, then work upward. The key is to keep the brace positioned properly while you secure it in place.[8]

   • Virtually every model of wrist splint uses multiple Velcro (or similar hook-and-loop closure) straps to stay in place. It will have an attachment strip on the body of the splint, which should be made of elastic, neoprene, or synthetic rubber.
   • Make the Velcro straps tight, but not uncomfortably so. If your fingers tingle or lose their normal color, the straps are definitely too tight.
   • Ask a medical professional for a demonstration on putting the splint on.

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   Check for skin irritation, joint stiffness, or muscle weakness. Every time you remove the splint, check your skin for any areas of significant redness, irritation, or even blistering. Also gently flex your wrist up, down, and around, and open and close your hand a few times, to gauge whether the joints have become stiff (or stiffer than before). Finally, pick up a few lightweight objects and evaluate whether you’ve developed any additional muscle weakness.[9]

   • This is only general advice—follow your doctor’s instructions on how and how often to perform such checks, if at all.
   • If you notice irritation, stiffness, or weakness, contact your doctor about possibly switching splints or altering when you wear one.
   • It's important to keep your wrist as dry as possible, since moisture, including sweat, can cause blisters or skin damage. You may notice that your skin rubs off if you sweat often.

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• Question

  How do I know if I need a wrist splint?

  

  Dr. Joel Giffin is a Doctor of Physical Therapy and the Founder of Flex Physical Therapy in New York, New York. With over 15 years of experience as a Certified Hand Therapist (CHT), Dr. Giffin treats the whole body and specializes in rehabilitation of the hand and upper extremities. He has treated Broadway theater performers backstage at shows such as The Lion King, Sleep No More, Tarzan, and Sister Act. Flex Physical Therapy also specializes in occupational and pelvic floor therapy. Dr. Giffin earned his Master’s degree in Physical Therapy with honors from Quinnipiac University and received his Doctor of Physical Therapy (DPT) degree with distinction from Simmons College. He is a member of the American Physical Therapy Association and the American Society of Hand Therapists.

  

  Physical Therapist

  Expert Answer

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  Ideally, you should see your physician, physical therapist, or certified hand therapist. They'll recommend one for you to use if it's appropriate. However, if you need to use something until you can get in to see your doctor, choose a splint that holds your wrist in a neutral position. Your wrist should feel more comfortable with the splint on—this isn't a "no pain, no gain" situation.

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• When you're wearing a wrist splint, it should hold your wrist in a neutral position, and it should not cause you any pain.[10]

  As a small thank you, we’d like to offer you a $30 gift card (valid at GoNift.com). Use it to try out great new products and services nationwide without paying full price—wine, food delivery, clothing and more. Enjoy!

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References

1. ↑ Joel Giffin, PT, DPT, CHT. Physical Therapist. Expert Interview. 22 October 2020.

About This Article

Article SummaryX

A wrist splint can help with carpal tunnel, arthritis, and other wrist pains. Remember to follow your doctor's instructions for how often to wear your wrist splint so you don’t stiffen your joints. If your doctor gives you a custom-molded resting splint, use it while you’re sleeping or if you experience a flare-up during the day. If you’re given a working splint, wear it during most everyday activities, but take it off regularly throughout the day to give your wrist a break. Keep using it for as long as your doctor advises, even if your wrist stops hurting. Make sure your wrist splint is tight but not uncomfortable. You don’t want to cut off the blood supply to your hand. For more tips from our Medical co-author, including how to get your wrist splint custom-fitted, read on.

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