Carpal Tunnel Syndrome Braces

Published Saturday, September 28, 2024 by Bryan

I want to geek out for a moment about wrist braces. I've worn one while sleeping occasionally for the past 20+ years to help alleviate Carpal Tunnel Syndrome (CTS) symptoms. I just found a completely new design during this year's replacement cycle, and I'm both absolutely delighted by it, and also enraged at what passes for CTS braces in the general U.S. market.

Two views of a grey neoprene wrist brace installed on a person's wrist, one from the top side of the arm, and one from the underside.
The generic wrist-immobilization brace found in most stores. This one is Ace brand, but demonstrates the basic set of features.

To help you understand my strong emotions, I feel the need to introduce you to the common wrist-immobilization brace you can find in any number of department stores, drug stores, and sporting goods stores in America. This is a soft fabric wrap with hook-and-loop straps to cinch it down on your arm. Pockets in the wrap hold 1-3 rigid metal splints. When the wrap is in-place, these splints keep your wrist from bending (too far). So far, whatever, they succeed in effectively limiting motion, and I imagine they're pretty effective for the common sprained wrist.

The underside view of the installed brace again, but this time with the metal splint laying on the outside of the brace, on top of where its pocket would hold it (further described in the next paragraph).
This splint's CTS-specific flaw is the metal splint that presses on the carpal tunnel.

But then they go and toss Carpal Tunnel Syndrome on the list of conditions it can be used for, and for that use, there's a huge problem in the form of that main splint. Its pocket runs along the underside of the arm, up into the palm of the hand. But at the base of the palm is the carpal tunnel. When the brace is tightened into place, that splint presses directly on exactly the place a CTS sufferer needs less pressure. The main objective - immobilization - is still reached, and that still helps reduce symptoms over time. But let me show you the design I've just found that works so much better.

Three views of a plastic brace installed on a person's arm: topside, underside, and underside again but with the palm visible through a window in the plastic. Arrows and celebratory emoji surround the window.
The Exoform® Carpal Tunnel Wrist, by Össur, my new prefered wrist brace. The liner is removed in the right-most view to better display the window over the base of the palm.

This brace replaces the encased metal splints with a unified, semi-rigid plastic exoskeleton. Look what that lets it do right at the base of the palm. It has a hole right over where the carpal tunnel will be. It places no pressure at all on that spot. It has been a revelation. I slept better the first night I wore it.

That's enough for this brace to be declared winner, but it's not where its improvements stop. Literally everything about this design is better. Without even moving focus away from the metal splints versus the plastic exoskeleton, there is another advantage: safety. Wear one of the common braces for long enough, and you'll find that those splints tear through the ends of their pockets. In the middle of the night, suddenly you'll find a bit of metal sticking out of the end of your brace. I never got the stab I feared most, but had plenty of scrapes. The plastic, though, since it's on the outside, is made to be touched. There are no stabby ends to speak of.

A four-panel diagram comparing the skin coverage of the two braces. Arrows point out large open areas on each side of the arm wearing the Exoform, that are completely covered on the arm wearing the generic Ace brace.
Breathable fabric can't compete with zero fabric when it comes to airflow.

Now compare the overall wrap. See how much more open space there is in the new design? My hand and arm stay much cooler when wearing it. This isn't just comfort for me. In the middle of summer, a hot wrap on my arm is likely to make me sleep almost as poorly as a few numb fingers. This is actually the reason I bought this brace to begin with. I couldn't see the hole over the carpal tunnel in the product pictures - I just saw the holes over all the other skin on my arm.

By the way, the side of the wrap also opens completey. No need to slide your hand through a tunnel to get the brace on and off. That's due to the wrap design, and also…

The top side of the arm wearing the Exoform brace. The straps closing the brace have been undone, revealing that they are simple clasps and that the arm is free to exit the brace sideways, instead of through the arm-end of the brace.
Simple clasps replace the hook-and-loop closures.

The completely different cinch straps! The new design isn't hook-and-loop, it's a simple clasp. This feature is amazing for the person sleeping next to me. If I wake up and need to get the brace off for whatever reason (like an itch), I don't make the Velcro™ krkrkrkrkrktktktkrkrktkt rip while doing it. I haven't had to remove it nearly as much as the old design, because of the vastly more open skin accessibility in general. But it's nice to know that I can without waking Amanda up.

The brace, held open with the liner removed. A finger is pointing to one of three hook-and-loop squares stuck to the inside of the plastic exoskeleton.
The liner is held in the brace by small hook-and-loop tabs.

Another thing that wasn't obvious from the product pictures is how the exoskeleton separates from the padded lining. That is hook-and-loop. Just a few small tabs around the corners of the plastic. That has made it very easy to clean. Because you know what happens to a brace you wear for eight hours a night? It gathers sweat and builds up an odor fast. The old brace style required removing and reinstalling those metal splints, a process that accelerates wearing through their pockets. Those pockets are also great at trapping moisture, so anything less than a trip through the dryer was likely to mean the brace wasn't fully dry before the next wear. The new design has no pockets to trap moisture, and the lining pulls away from and reinstalls onto the hook-and-loop patches easily. I give the exoskeleton and the liner each a quick hand-wash sometime in the afternoon, hang them up somewhere, and by night time they're fresh and dry.

Why haven't I switched brace styles before now? Mostly, this is the first time I've found any other brace style. I've searched many times over two decades. I always end up with the biggest difference being color and number of securing straps. This is the first time I've found anything else. Aggravatingly, it was on one of the SEO-optimized "best carpal tunnel braces" spam pages that pollute the internet. You better believe I spent a good amount of time researching to make sure it wasn't some bit of cheap junk before ordering.

I also hadn't searched farther than the basic options because that style is what the doctor gave me after my first diagnosis. The only difference was that the "fabric" of that one was that awful pink-skin-color vinyl-backed felt stuff you only ever see used in medical devices. It had exactly the same brace arrangement otherwise.

What bothers me so much about these generic braces being marketed for CTS treatment is that it blocks better solutions from gaining traction in the market. Other injuries, like sprains, are obviously far more common. So every store that is going to stock a brace is going to stock the one that treats sprains. If that brace also says, "Treats Carpal Tunnel Syndrome," they have no reason to stock another option. The other option is head-and-shoulders (wrist-and-hands?) better for CTS, though.

Meanwhile, I think the actual CTS brace undersells itself. I haven't decided what to blame this on yet, but it has the smell of a professional science and engineering team that doesn't market the killer feature, because in their eyes anything that doesn't have that feature isn't a competitor. Or to put it the other way, every CTS-specific brace has that hole, so there's no reason to even bring it up.

So this post is my way of doing the advertising for them. If you have also been frustrated by the brace options available to treat your own Carpal Tunnel Syndrome, give the Exoform® Carpal Tunnel Wrist, by Össur a serious look. It's so much better than any other brace I've owned, that I'm considering ordering a second just in case it's not available when I eventually need a replacement in another few years.

Categories: Miscellaneous