Cock-Up Splint vs. Wrist Brace: Which Is Better for Carpal Tunnel?
Is a cockup splint better than a wrist brace?
The Quick Answer
**No significant difference in efficacy**—studies show neutral and cock-up splints provide equivalent carpal tunnel symptom relief when worn consistently at night. Selection should prioritize **patient comfort and adherence** rather than splint angle. Rigid splints (cock-up or neutral) outperform flexible braces for nocturnal protection; flexible braces suit daytime activity modification only.
Why We Ask This
Patients seek the 'optimal' splint design believing minor angle differences dramatically impact outcomes—overlooking that adherence (wearing it consistently every night) matters far more than 10° variations in wrist positioning between neutral and cock-up designs.
The Practical Science
AAFP-reviewed studies directly comparing neutral versus cock-up splints found no statistically significant difference in symptom reduction, nerve conduction improvement, or functional outcomes at 8 weeks—both designs effectively prevent harmful nocturnal flexion when worn consistently.
In Clinical Practice
A patient tries a neutral splint first but finds the palmar strap uncomfortable during sleep—switching to a cock-up design with dorsal support improves adherence to nightly wear, resulting in 70% symptom reduction after 8 weeks versus inconsistent use with the neutral design.
References & Context
Best Treatment Approaches for Carpal Tunnel Syndrome - AAFP"First, the authors assert that "there is good evidence supporting the use of neutral and cock-up wrist splints, with similar symptom relief outcomes with both styles." Although neutral and cock-up splints have been shown to relieve symptoms of carpal tunnel syndrome, two studies directly comparing neutral and cock-up ...Mar 15, 2012"