Some people make crucial mistakes when buying and using a carpal tunnel hand brace (also called a carpal tunnel wrist brace). As a result, their painful or numbing condition never goes away completely. In fact, it's very common to try a brace only to find that your symptoms worsen.

Why? Either you purchased the wrong type of brace or you are using it improperly.

This is both sad and ironic. Suffering patients buy braces to relieve conditions like tendonitis or carpal tunnel syndrome, not make them worse. Yet, when properly used, a brace is one of the most effective carpal tunnel syndrome treatments.

This article highlights 2 important things about selecting a hand brace for carpal tunnel syndrome (the most common hand disorder in the USA):

1. What to look for (and avoid) when you select a carpal tunnel brace.
2. How to properly use a hand brace to eliminate carpal tunnel symptoms.

• FIND OUT: do you have carpal tunnel? No strings attached self-test.
  

Most people use the terms “splint” and “brace” interchangeably. But they actually mean two different things. Both are considered medical devices.

• A splint is used to completely immobilize a particular joint.
• A brace is used to limit the motion of a joint & support it through that movement.

Those two functions are very similar when it comes to the hand and wrist. In fact, the majority of braces and splints perform identical functions. For now, we'll refer to them as a “carpal tunnel hand brace”.

Hand braces are by far the most common therapies people use to help with their carpal tunnel symptoms. Doctors prescribe a hand brace for patients almost as often as pain relievers when patients complain of hand pain or finger numbness.

But even most doctors fail to realize that carpal tunnel syndrome is a unique condition with very specific issues. Therefore, not just ANY generic brace sold in your local pharmacy can address those issues and help relieve symptoms.

Actually, wearing just any old hand brace for carpal tunnel syndrome is like wearing a car tire for a shirt; it’s not only silly, but can it be harmful.

Before identifying the biggest mistakes in using a carpal tunnel hand brace, here's what you must look for. The best hand brace for treating carpal tunnel syndrome is certified by carpal tunnel doctors.

Wearing a hand brace to support your wrist is great for conditions like sprains and arthritis. They help you reduce strain when you work which could otherwise cause stress and pain. 

But contrary to what carpal tunnel syndrome doctors usually advise, you should not wear a carpal tunnel hand brace 24/7. In other words, never wear a brace during the day as you work. Completely restricting your wrist while working can be harmful.

Your wrist should not be restricted for two reasons. 

• First, wearing a hand brace while working makes you subconsciously fight it. You don’t really sense it, but essentially your hand is doing a lot of mini isometric exercise (moving against an immovable force). Since carpal tunnel syndrome is a problem with inflamed tendons , this extra stress is harmful to your already sick tendons. So the hand brace stresses your hand even more than if you didn’t wear it.
  
  
• The second reason to not wear a carpal tunnel hand brace when you work is because your wrist needs to bend and move when you have carpal tunnel syndrome. Bending is the only way the body can pump out excess fluid build-up from inside the wrist joint. (See Mistake # 4 below.)

Fluid build-up is what causes pressure deep inside the wrist joint, eventually crushing the median nerve. That’s what gives you symptoms like pain and numbness with carpal tunnel syndrome. Drain the fluid and you relieve the pressure.

Nearly 98% of hand braces have a "palmar spine". That’s the metal stiffener on the palm side of the brace. It’s a good feature to have if you suffer from a sprained wrist or arthritis. In those cases, you need to restrict wrist movement in order to avoid pain. 

But if you have carpal tunnel syndrome, you might as well let someone stand on your wrist. That metal spine only serves to damage the interior of your wrist joint and further increase internal pressure.

How does the metal spine increase pressure? It happens when we bend our hand backward (i.e., extending the wrist joint). 

With a metal spine there, bending the wrist backward will press that spine into your carpal tunnel space. As a result, the pressing will increase pressure inside the wrist. And increased pressure means more compression of the median nerve, which causes more pain and numbness.

After sleeping with this kind of carpal tunnel hand brace, many patents wake up in the morning with an even more painful or tingly hand. That spine is the likely reason why. 

Unfortunately, if you simply remove the spine from the brace, it loses rigidity and stability. 

A certified carpal tunnel hand brace is sturdy without having a spine on the palm side.

As discussed in Mistake # 2 above, restricting you wrist movement while working when you have carpal tunnel syndrome is harmful. Your hand tends to fight the restriction, and that’s bad for your already strained tendons. 

Also, free joint movement is the only way the body can pump excess fluid out & away from a joint. With carpal tunnel syndrome, inflamed tendons cause fluid build-up deep inside the wrist. That excess fluid is the root cause of carpal tunnel syndrome, and must be allowed to drain away. If it doesn’t, the fluid simply builds up and causes more damage. 

In addition, if you have carpal tunnel syndrome, tight constriction impedes blood flow in the joint. The tighter the constriction, the less blood gets in (and the less fluid is able to drain out). 

A certified carpal tunnel hand brace will not constrict your hand or wrist.

Now we know if you have carpal tunnel, bracing your hand during the day is harmful. In contrast, you absolutely must wear a hand brace when you sleep. 

When we sleep, we unconsciously bend our hands. Some people keep their hands bent forward while others keep them bent backward. And you can maintain this position for several hours at a time. That's very harmful.

If you have carpal tunnel syndrome, any  hyper-bending of the wrist is bad. That’s because it constricts the carpal tunnel space, which adds pressure to the median nerve. And that’s why it’s important to brace your hand in a neutral (straight) position while you sleep.

As discussed above, wearing a hand brace at night with a metal spine is doubly harmful. Bending the hand backward is bad enough. But the metal spine will also force itself against your wrist joint. That greatly increases the pressure inside your wrist.

Therefore, you must brace at night. And you must make sure there's NO  metal spine on the palmar surface of the carpal tunnel hand brace you sleep with.

Every day, I can count on at least one patient telling me, “I wanted a good brace, so I bought one for $400.” My response is always, “I hope you saved the receipt….return it!”

I’m a veteran brace designer and I know braces inside and out. I've never seen good justification for buying a $400 brace compared to a $50 brace. Basically, braces are like T-shirts; the cheaper ones are just as good as the expensive ones. But again, no braces sold in pharmacies are designed for carpal tunnel syndrome.

That means the very low-end, cheap, generic, discount store braces you buy from CVS, Walgreens, Wal-Mart, etc. are not a certified carpal tunnel hand brace. They're mass produced in Asia for pennies and sell in the USA for under $20. Those hand braces re almost always inferior in quality and workmanship. Most of them don’t last through more than a couple washes, and don’t provide good joint support. They're usually uncomfortable or irritating. Most importantly, they are NOT certified carpal tunnel hand braces. 

I estimate that the vast majority of good quality braces sell between $30 and $60. But no matter the price, what makes a brace “good quality” is its construction and the features you need for your particular condition. 

Without being repetitive, these braces may be great for a sprain, but they likely are not designed for carpal tunnel syndrome. (See Mistake # 7 below.)

Many brace manufacturers use the same brace design for every condition you can imagine: sprains, arthritis, and even carpal tunnel syndrome. But nearly all of these manufacturers fail to understand that carpal tunnel syndrome has unique issues which are incompatible with treating sprains, arthritis, etc.

Therefore, if the brace package states “treats carpal tunnel syndrome”, then be skeptical. Look for the specific features described below. These features are what constitutes a certified  carpal tunnel hand brace. (The main feature is it should not have a palmar spine.)

I have listed the 9 currently known certified carpal tunnel braces here.

A common mistake carpal tunnel sufferers make is thinking that just slapping on any old hand brace will make symptoms go away.   It won’t. 



Night bracing is just one component of an arsenal of remedies that must be used in tandem to support each other.

For instance, with mild stage carpal tunnel syndrome , using to night brace might be enough. It usually is.

But with moderate stage carpal tunnel syndrome you must also incorporate daily stretching exercises for your fingers and hands. You don’t have to spend hours doing them. I've created excellent stretching exercises that take only 30 seconds to do for every half hour you work. They're amazingly effective!

However, if you have severe stage carpal tunnel syndrome , you must do more. It’s important to incorporate myofascial release massage in addition to bracing and exercises. Unfortunately, you cannot easily perform myofascial release massage on yourself because you need 2 thumbs to do it. Therefore, find a willing and able partner who can help. You need this therapy a minimum of once daily for about 30 days along with a nightly carpal tunnel hand brace and regular stretching exercises.

A thumb spica is a brace that has a stiff support (spica) for the thumb. These are necessary for thumb sprains or fractures. They're also useful for de Quervain’s tenosynovitis. That’s a condition caused by inflammation of the tendons controlling thumb extension.

When such disorders make thumb movement painful, the thumb joint needs rest while the other fingers work. In that case, a brace with a thumb spica is perfect. However, if you don’t have thumb issues, the thumb spica is not necessary.

Unfortunately, many people with carpal tunnel syndrome use a brace with a thumb spica. That’s because carpal tunnel syndrome often causes pain more in the thumb and first finger. So immobilizing the thumb sounds like a good idea, but it’s not. Wearing a thumb spica to restrict thumb movement is harmful for all of the reasons given in Mistakes # 2 & # 4 above. 

A certified carpal tunnel hand brace will not have a thumb spica.

I’ve spent a career taking flak from colleagues for this one...

Most doctors are well-meaning and unselfish. It’s the very foundation for pursuing a career in medicine. 

Of course, there are some doctors who don’t care about their patients. But happily, they’re rare.

The real problem is that most doctors, as in all professions, follow what the mainstream does. Unfortunately, the mainstream is not always right. That’s because the majority of conventional wisdom does not keep pace with the ever-advancing science of medicine.

The best example is when doctors advise carpal tunnel patients to “just wear a hand brace”. That implies to the patient that they should wear a brace 24/7. While that’s good advice for most hand problems like arthritis, sprains or fractures  - it's not good for carpal tunnel syndrome.

Most general practitioners simply don’t understand the nuances of treating carpal tunnel syndrome. They don’t appreciate the special physiological circumstances that makes ordinary bracing painful or even harmful.

Therefore, if your doctor advises that you wear any old carpal tunnel hand brace (especially all the time), then pause. He or she is probably not up to date with the science of carpal tunnel syndrome.

After reading this article, you actually know more about it than your doctor!