What Is a Cock-Up Splint Used For? Carpal Tunnel Relief
What is a cock up splint used for?
The Quick Answer
A **cock-up splint** maintains the wrist in 20–30° extension to relieve pressure on the median nerve in carpal tunnel syndrome. Unlike neutral splints, its dorsally angled design specifically counters nocturnal wrist flexion—the primary mechanism increasing carpal tunnel pressure during sleep. Evidence shows both neutral and cock-up designs provide similar symptom relief when worn consistently at night.
Why We Ask This
Patients seek 'stronger' splint designs believing greater wrist extension equals better outcomes—unaware that excessive extension (>30°) can compress the ulnar nerve or strain dorsal wrist structures, potentially worsening symptoms despite good intentions.
The Practical Science
Cock-up splints position the wrist in mild extension where carpal tunnel cross-sectional area increases by 8–10% versus neutral position—reducing pressure on the median nerve. However, studies comparing neutral versus cock-up designs show equivalent clinical outcomes when worn consistently, suggesting patient comfort and adherence matter more than minor angle differences.
In Clinical Practice
A patient with severe nocturnal carpal tunnel symptoms tries both neutral and cock-up splints—the cock-up design proves more comfortable during sleep due to reduced palmar pressure, leading to better adherence and 60% symptom reduction after 8 weeks of nightly use.
References & Context
Cock Up Splint - Orthoderm Speciality Centre"Cock-up splints are often prescribed for patients with CTS to immobilize the wrist, keeping it in a neutral position that relieves nerve compression."