Treatment of hand and wrist pain. A randomized clinical trial of high voltage pulsed, direct current built into a wrist splint.

To determine the effectiveness of high voltage pulsed current (HVPC) in reducing chronic hand edema, 120 individuals were randomly assigned to one of two treatment groups. Group I clients were given an appropriate sized wrist splint, incorporating an energized, high voltage pulsed unit. Group II clients were given an identical splint with a non-energized unit. Each client received daily treatments at the worksite consisting of 30 minute sessions totaling 20 treatments during a 35 day period. Pre-treatment and post-treatment evaluations included measurements of pain, grip strength, and edema volume; repetitive task testing; and Semmes-Weinstein Monofilament sensory testing. In the energized group, post-treatment evaluation showed statistically significant decreases in the amount of stimulation required to stimulate the median nerve and the amount of hand edema and pain. The energized group also had improved repetitive task times. None of these improvements occurred in the non-energized group. Based on these results, HVPC appears to be an effective method for minimizing the severity of repetitive stress injuries of the wrist.