NEJM Evid
Rigid wrist splints fall short against placebo in carpal tunnel trial
Clinical takeaway: For patients with carpal tunnel syndrome, rigid wrist splinting may offer no clear advantage over placebo; clinicians should set expectations accordingly and consider earlier use of alternative evidence-based options (e.g., corticosteroid injection or surgical evaluation) when symptoms persist.
In a randomized, double-blind trial, investigators compared a rigid wrist splint with a placebo soft bandage that allowed full wrist motion in patients with primary idiopathic carpal tunnel syndrome. Over 12 weeks, both groups reported small improvements in symptoms, but there was no statistically or clinically meaningful difference between splinting and placebo on the six-item CTS symptom score. At 1 year, rates of subsequent carpal tunnel surgery were also similar (≈55% in both groups). Minor local adverse effects occurred at comparable frequencies, with no serious events reported. These findings suggest that the symptomatic improvement often attributed to wrist splinting may largely reflect nonspecific or placebo effects rather than true biomechanical benefit.
Source:
Atroshi I, et al. (2026, March 24). NEJM Evid. Wrist Splinting versus a Placebo Soft Bandage for Carpal Tunnel Syndrome. https://pubmed.ncbi.nlm.nih.gov/41874253/
