Wrist and arm braces

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

From the Occupational Safety and Health Administration

Ergonomic issues are common conditions that affect the upper or lower extremities.

Ergonomic disorders may be caused or aggravated by repetitive motion, forceful exertion, vibration, sustained and/or awkward positioning of the body, or mechanical compression of the joints.

Muscle strains and sprains occur from over-exertion or repetitive motion. Common symptoms include muscle fatigue and pain in the shoulders, neck, wrists, and lower back.

Repetitive stress injury is defined as disorders of the muscles, tendons, or nerves caused by repeated mechanical stress to a particular part of the body – most commonly the hands, wrists, arms, or shoulders. Research has shown that the contributing factors tend to be the amount of force exerted, frequency of the repetitive motion, sustained posture, nerve compression, and insufficient rest or recovery time. Whether or not the condition is work or non-work related is often difficult to ascertain since activities such as weekend sports, carpentry, gardening, playing an instrument, or sewing can predispose employees to CTDs.

CTDs can be categorized by the physiologic group of the body affected. Some examples include:

Muscle Problems
Myalgia (general term for muscle pain)
Myofacial pain syndrome (irritation of the membrane surrounding muscle)

Tendon Problems
Tendonitis (irritation of a tendon, often accompanied by pain)
Tenosynovitis (irritation of the sheath surrounding a tendon)
Dequervain’s disease (tenosynovitis at base of thumb)
Epicondylitis (irritation of the tendon attachments at the elbow, i.e., tennis elbow, golfer’s elbow)
Trigger finger (a type of extreme tenosynovitis leading to locked fingers)

Nerve Problems
Carpal Tunnel Syndrome (damage to the median nerve passing through the wrist area)
Guyon’s Canal Syndrome (damage to another of the three nerves passing through wrist)
Cubital Tunnel Syndrome (damage to a nerve passing through elbow)
Thoracic Outlet Syndrome (compression of the nerves and blood vessels between neck and shoulder)
Hypothenar Hammer Syndrome (nerve damage from repeated impacts at base of palm)

Because many types of conditions fall under the category of ergonomically-related disorders and injuries, their symptoms and diagnosis are different. Some typical symptoms include persistent pain in a functionally-affected area of the body, tingling and numbness, or a feeling of heat in the affected area. Symptoms usually occur while performing the activity and may persist into resting times, often becoming more intense during the night.

Like diagnosis, treatment of ergonomically-related conditions depends upon the severity and duration of the condition, as well as modification of the source of the problem. Early diagnosis and treatment is more effective than later treatment. Mild cases of most cumulative trauma disorders, when detected early, can be successfully treated with anti-inflammatory drugs, rest or restricted activities, and, in certain cases, physical therapy. More severe cases often require prolonged rest, anti-inflammatory drugs, immobilizing splints or supports, heat or ice treatments, and physical therapy. Surgery is sometimes also indicated in a very small fraction of severe cases, but should be considered only after all other options have been explored.

Many people inquire about the use of wrist braces, arm or elbow braces and the such as a way to prevent various ergonomically-related disorders. These kinds of inquiries have become more numerous as public awareness of ergonomics has increased, and as organizations and corporations address ergonomics for their staff.

Although all of these kinds of devices can provide relief in the treatment of ergonomically-related conditions, the scientific evidence to date on their preventive use has been inconclusive at best. The routine use of wrist supports or braces during keyboarding restricts motion of the hands, can reduce blood flow and pinch nerves, and ultimately redirects forces from the wrist to the forearm.

Various types of splints, supports, and braces can play an important part in physical rehabilitation by restricting ergonomically-poor motions or isolating affected musculo-skeletal elements. This is important in severe cases of carpal tunnel syndrome, where the wrist needs to remain straight during recovery, especially during sleeping hours when many people tend to curl their wrists.

Given the inconclusive nature of the available data to date, coupled with the potential harm that can be caused by their indiscriminant use, requests for these kinds of devices must be evaluated by a medical expert and an assessment of the work task(s) performed.

If splints or braces are recommended, make sure the fit and the type of brace is correct for your problem.

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