Carpal Tunnel Brace suggestions?

Athenor

For the last few months, I've been waking up with my fingers tingling, and my right hand goes numb if I play games before noon or so. I figured it was just me being out of shape, but a post here made me re-evaluate and think it was the first signs of carpal tunnel syndrome. As someone who has been playing video games since 6 and using computers even longer, well.. I don't want surgery or anything like that.

The first answer, of course, is to get a doctor's appointment. But I need to change GPs, and I don't know who to see about this.

In the meantime, I've heard braces can help. I picked up some from CVS this morning at random, and realized I didn't do any research or shopping around. I don't even know if they fit properly (though I think they do).

Does anyone have experience with wrist braces? Fully recognizing that I need to see a doctor and not self-diagnose, I was wondering:

1) Are there any brands or types of braces that work better?
2) How often do you wear them?
3) Should I return these, which are from some company named Futuro?

Henroid

I don't know about brands, but I have a wrist brace I wear on my dominant hand. It has a metal bar in a sleeve, which helps keep your wrist straight and steady. I did some reading a week or so ago, and it's better to wear such braces when you're not active with the wrist in question. It's better to wear during downtime, otherwise you're actually persisting the buildup of fluids in the wrist (which can cause pain, swelling, etc). So never wear a brace while playing games or doing a lot of computer work. I also saw some advice and feedback that it can help a lot to wear the brace at night when you sleep. At worse, you're just dealing with the discomfort of wearing it. No adverse side-effects.

This kind of brace I have isn't the best for compression though, if that's what you're after. It's merely for keeping the wrist straight and thus a bit more relaxed.

VishNub

I had, and still have, occasional tendinitis in both wrists. I found that wearing a wrist brace while sleeping was helpful, in the sense that I didn't have to worry about making sure my wrist was supported.

I had this one

https://www.amazon.com/Mueller-Fitted-Wrist-Brace-Number/dp/B002NLGNW8/ref=sr_1_4_s_it?s=hpc&ie=UTF8&qid=1489207444&sr=1-4&keywords=wrist+brace

I have a left and a right one, for when I occasionally get sore. They do sometimes ride up and put pressure against the webbing near my thumb, which is uncomfortable. Otherwise I like them.

But I never saw a doctor and it went away eventually. Obviously can't recommend that strategy.

Athenor

That's part of the reason I started this thread - the brace I got was $27 per hand.. so.. ugh.

Even Amazon has them cheaper... https://www.amazon.com/dp/B0057D7ZQC/ref=twister_B0078K4JIO?_encoding=UTF8&psc=1

Casual Eddy

I have some braces but Im not sure what kind. I think they come from a doctor but otherwise I can't tell you much about them.

my understanding of the issue is that it is due too inflammation, overuse, and an imbalance in strength in the wrists. Take anti-inflammatories daily if you're able to and ice your wrists/arms after long use.

You may want to purchase a vertical mouse - https://www.amazon.com/Evoluent-VerticalMouse-Regular-Right-VM4R/dp/B00427TAIK if the problem is mainly in your mouse hand. notice if you put your hand flat there's a bit of tension compared to holding it in a karate chop position. I found it to be helpful but they are a bit pricy

I also highly recommend a theraband to strengthen your wrists/forearms : https://www.amazon.com/TheraBand-Resistance-Epicondylitis-Tendonitis-Intermediate/dp/B000KGOMBC/ref=pd_lpo_328_bs_img_2?_encoding=UTF8&psc=1&refRID=4ZHC5FE3ZEXH1KSRB64S

use it 1-2 times a day. there are videos on how to use them.

if you're able to get braces, definitely sleep with them on fairly tight in addition to using them at a computer. I sleep on my arms funny and that created a lot of pain when I woke up

also your posture is important. make sure the screen is roughly at eye level, you are sitting up straight, and your arms are roughly bent at 90 degrees.

basically you want to attack the issue from as many angles as possible to help calm the inflammation. it's unlikely that you'll need surgery if you treat it early - I was in significant pain on a daily basis but it went away by following the above steps religiously. I also got the numbness/tingling which is a sign of the nerves being compressed due to inflammation.

if you see a doctor they can recommend physical therapy, and they can teach you additional exercises.

I am in a coding bootcamp at the moment and am using a computer 12+ hours a day and not having a problem with my wrists.

dispatch.o

I suggest you see a doctor so they can run a few tests on any nerve involvement and see if you need surgery. The scar tissue wont be going away because you wear a brace and the damage can eventually become permanent if it's not caught early and surgery is necessary. It's entirely possible no surgery is necessary, but you best know before you try to treat this yourself.

Athenor

Yeah. Regardless of what I do, the doctor's happening.

That said? Holy cow. The braces made a huge difference. I think the very tips of my fingers are tingling a little, but I might also be paranoid. The big thing is that my hands are not tingling and feeling numb.

However, the braces were still kinda tight despite my trying to adjust them as much as I can. I have some pretty deep marks on my skin. Hence the asking for recommendations.

Enc

Athenor wrote: »

For the last few months, I've been waking up with my fingers tingling, and my right hand goes numb if I play games before noon or so. I figured it was just me being out of shape, but a post here made me re-evaluate and think it was the first signs of carpal tunnel syndrome. As someone who has been playing video games since 6 and using computers even longer, well.. I don't want surgery or anything like that.

The first answer, of course, is to get a doctor's appointment. But I need to change GPs, and I don't know who to see about this.

In the meantime, I've heard braces can help. I picked up some from CVS this morning at random, and realized I didn't do any research or shopping around. I don't even know if they fit properly (though I think they do).

Does anyone have experience with wrist braces? Fully recognizing that I need to see a doctor and not self-diagnose, I was wondering:

1) Are there any brands or types of braces that work better?
2) How often do you wear them?
3) Should I return these, which are from some company named Futuro?

My wife has carpal tunnel, really anything you can get for 10 bucks at the pharmacy will do. The point is to splint your hand to keep your wrist steady, there isn't much to it.

Her doctor wants her to wear it when she sleeps. She occasionally wears it at work, but generally not. It doesn't cure the problem, nor lessens aggravation. Its more of a preventative so it doesnt hurt as much the next day.

Windburn

@Athenor Carpal Tunnel Syndrome is extremely common, but there are other causes of numbness and tingling in your hands. In order to recommend the appropriate brace, it's important to know which nerve(s) is(are) the culprit. A focused physical exam is necessary to confirm the diagnosis, but the history is most instructive. With that in mind, please answer the following questions:

1. Is it both hands equally or one more than the other?
2. Which fingers are affected and which are spared (if any)?
3. When you get symptoms while playing games, are they KBAM or controller?
4. Do you have a history of any other neuropathies?
5. Are you overweight?
6. Do you smoke?

If you would rather not answer these in a public forum, you may PM me instead.

Athenor

Windburn wrote: »

@Athenor Carpal Tunnel Syndrome is extremely common, but there are other causes of numbness and tingling in your hands. In order to recommend the appropriate brace, it's important to know which nerve(s) is(are) the culprit. A focused physical exam is necessary to confirm the diagnosis, but the history is most instructive. With that in mind, please answer the following questions:

1. Is it both hands equally or one more than the other?
2. Which fingers are affected and which are spared (if any)?
3. When you get symptoms while playing games, are they KBAM or controller?
4. Do you have a history of any other neuropathies?
5. Are you overweight?
6. Do you smoke?

If you would rather not answer these in a public forum, you may PM me instead.

1) Both equally, though more common in the right hand it seems like. Left is my dominant.
2) All of them? Like I haven't been paying that much attention.
3) Controller, though I have a history of laying on my stomach and using my PC, so keyboard can sometimes have problems.
4) Dunno... I do have Lymphadema in my legs due to being stupid about 4-5 years ago and wearing too tight of socks, which caused my lymph nodes to start to fail and has led to purple discoloration and slow healing.
5) Unbelievably so. (450lbs, probably higher right now. >.< )
6) Never in my life.

Windburn

Athenor wrote: »

2) All of them? Like I haven't been paying that much attention.

This is important. Pay particular attention to whether the pinkie finger is spared or not.

The answer will indicate whether the median nerve or ulnar nerve is the culprit. If it's true that the entire hand is involved, then it's most likely coming from your c-spine.

Athenor

Windburn wrote: »

Athenor wrote: »

2) All of them? Like I haven't been paying that much attention.

This is important. Pay particular attention to whether the pinkie finger is spared or not.

The answer will indicate whether the median nerve or ulnar nerve is the culprit. If it's true that the entire hand is involved, then it's most likely coming from your c-spine.

Paying attention when waking up this morning, my pinky seems unaffected.

Windburn

Ok, so your history is consistent with a median nerve neuropathy. The most common site of compression is at the carpal tunnel.

I am traveling now, so I will write a longer post later explaining things in more detail. To answer your question, you need a "wrist cock-up brace".

http://3.imimg.com/data3/CG/GY/MY-2482252/cock-up-wrist-splint-500x500.jpg

Brand isn't a major factor. General rule, don't buy the cheapest or the most expensive. They should be tight, but not painful or restricting blood flow. If you can slide your hand out of them without having to release the Velcro, it's too loose.
You should wear them at night to start. If you are still having symptoms during the day, wear them only during activities that are aggravating. Do not wear them all the time.

More later.

Athenor

Thanks man.

Yeah, that looks like the ones I have now, but I worry they are too tight. I bought the "L/XL" ones, but.. well.. here's what my hands look like after waking up..








I just got them Friday, so I can return them I'm sure.

Windburn

Athenor, sorry for the delayed response. That does look a little tight. More importantly, is it painful or cause numbness/tingling? If not, then it's fine to continue using in the short term. If it does hurt, you should return it for a larger brace. Eventually, you might need a custom brace from an OT (occupational therapist) if you have an atypical frame.

I don't want to presume a lack of knowledge on this topic or your ability to look up information. If you would like me to post some information on the pathophysiology of carpal tunnel syndrome, I am more than happy to do so. Just say the word.

Athenor

Please do. I'm assuming you are a doc or in the medical field somehow. The braces are pretty much as loose as I can make them (which is helping), but the tingling returns a bit after taking them off when I'm going about my daily routine.

Dhalphir

I had mild forearm/wrist pain a while ago, and improved it by following these exercises. I did them at least twice daily (when I woke up, and when I went to sleep) or more if I remembered. Sitting in the car at traffic lights, waiting for a loading screen, that kind of thing.

I'm not a doctor, but they helped me, and I'd be surprised if they can hurt.

Windburn

With respect to well meaning intentions from @Dhalphir, those exercises are for musculotendinous problems, not nervous (which is what CTS is). In fact, #3 will likely trigger your symptoms. It is similar to the physical exam maneuver to diagnose CTS called Phalen's maneuver.

To understand CTS you must first understand what the carpal tunnel is. In your wrist you have a series of small bones called carpal bones. They give your wrist and palm dexterity to grip varied and irregular objects. On the palm side of your hand, four of these bones form a sort of bowl with a ligament "roof". This is the carpal tunnel and nine tendons and one nerve run through it to get from the forearm to the hand.

This tunnel is not elastic, so anything that increases in volume in this tunnel will put pressure on the median nerve. Nerves do not tolerate direct pressure and will stop working. If you have ever had your arm "fall asleep" and had the pins and needles sensation, you know what I'm talking about.

There are a lot of things that can change the volume of the contents of the carpal tunnel. The first is position. The carpal bones shift and move as you move your wrist. In a flexed position, the volume of the carpal tunnel decreases. Most people sleep with their wrists flexed (whether you think you do or not). This prolonged position causes the median nerve to "fall asleep" and you wake up with nimbleness, tingling, and pain on the radial side of your hand. Hence the role of cock-up wrist braces. They prevent you from flexing your wrist at night.

Other causes are tendonitis. Inflammation of a tendon will cause it to swell. This can put pressure on the median nerve. This is the proposed etiology of repetitive activity causing CTS (though this has been called into question recently). Repetitive activity can cause irritation of a tendon, leading to tenonitis and swelling of the tendon. Once the inflammation is under control, the exercises posted by @Dhalphir may help prevent it from happening again.

Some medical causes include hyperthyroidism and pregnancy, though "how" is a mostly speculation. Rheumatoid arthritis can cause CTS, probably through a change in geometry of the carpal bones. Tumors are fortunately rare, but can also create a mass effect within the carpal tunnel.

Treatment for CTS is dependent on the cause, but common things are common. So we usually start with night braces, rest, and NSAIDs. It isn't a good use of resources to jump straight to an MRI to look for the extremely rare tumor or blood tests for endocrine disorders. If the above fail to resolve symptoms (bear in mind, it can take several months), you can consider steroid injections into the carpal tunnel. Think of this as a high powered, localized anti-inflammatory.

Finally surgery (my area): a small incision to sever the transverse carpal ligament. This relieves pressure in the carpal tunnel, whatever the cause is. It is an extremely common procedure with very low risks, but is not risk-free. For this reason, I stress that a patient must fail conservative treatment first before considering surgery.

If you have any questions or would like me to expand on anything above, please ask. Otherwise, best of luck to you. I hope this is a transient problem that resolves quickly and without the need for injections or surgery.