American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended initial management for carpal tunnel syndrome with mild symptoms?

1. Wrist splinting

2. Physical therapy

3. Open carpal tunnel release

4. Regular corticosteroid injections

The correct answer is: Wrist splinting

Wrist splinting is the recommended initial management for carpal tunnel syndrome with mild symptoms because it helps to immobilize the wrist in a neutral position, reducing pressure on the median nerve. This conservative approach is effective in alleviating symptoms such as pain, tingling, or numbness in the fingers that are often associated with this condition. Mild symptoms indicate that the condition has not yet progressed to a stage requiring more invasive treatments. Splinting, particularly at night or during activities that exacerbate symptoms, can provide significant relief. It is typically the first-line intervention before considering other options such as physical therapy or corticosteroid injections, which may be useful in managing symptoms but are not usually the first step for mild cases. Surgery is generally reserved for cases where conservative management fails or symptoms are more severe. In summary, wrist splinting effectively addresses mild carpal tunnel syndrome symptoms through a non-invasive, supportive approach, making it the appropriate initial management strategy.