Treatment of carpal tunnel syndrome with medical acupuncture

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Authors: Robert A. Schulman and Brian Liem
Date: Sept. 2008
From: Medical Acupuncture(Vol. 20, Issue 3)
Publisher: Mary Ann Liebert, Inc.
Document Type: Clinical report
Length: 2,334 words

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ABSTRACT

Background: Conservative management plays an important role in the treatment of carpal tunnel syndrome. Non-surgical options include physical and occupational therapy, splints, steroid injections, yoga, carpal bone mobilization, and anti-inflammatory drugs. Clinical experience demonstrates that acupuncture should be considered among these treatments as it may provide symptomatic relief to patients with this disorder.

Objective: To demonstrate an acupuncture protocol for the treatment of carpal tunnel syndrome.

Design, Setting, and Patients: Seventeen patients with electrodiagnostically confirmed carpal tunnel syndrome treated by a solo medical acupuncture practitioner for carpal tunnel syndrome. Patients were seen between 1998 and 2007 at the practitioner's New York office.

Intervention: Needling of PC 6, PC 7, TH 5, and Baxie 1 and 2 points. Most patients additionally received osteopathic manual therapy.

Main Outcome Measure: Patient-reported symptom relief.

Results: Twelve of 17 patients had partial or complete symptom relief with treatment. Two patients' symptoms were considered too severe for acupuncture treatment. The remaining 3 patients had no appreciable change in their symptoms.

Conclusion: The acupuncture method described herein can be an effective treatment for mild to moderate carpal tunnel syndrome. This report should prompt a larger prospective trial.

Key Words: Acupuncture, Carpal Tunnel, OMT

INTRODUCTION

CARPAL TUNNEL SYNDROME is a compression disorder of the median nerve as it passes underneath the transverse carpal ligament, causing paresthesias in the palm and first 3 1/2 digits of the affected hand. Patients typically complain of numbness, tingling, and pain in the hand which worsens at night, and is often relieved by shaking or rubbing of the hand. (1,2) Other symptoms may include shoulder pain and headaches. Compression is commonly due to increased edema in the carpal tunnel secondary to overuse of the wrist from excessive flexion and extension, as can be seen in such occupations as meatpacking and automobile assembly line work. (3) Other causes of carpal tunnel syndrome include diabetes, hypothyroidism, rheumatoid arthritis, pregnancy, lupus, congestive heart failure, and obesity. (4) Presenting patients may be of any age, but typically range from 30 to 60 years, with women affected more frequently than men. (5)

Conservative treatments for carpal tunnel syndrome may include wrist splints, steroid injections, anti-inflammatory medications, osteopathic manipulation, (6) and changes to the work environment. (7) Steroid injections may provide effective pain relief; however, the benefits may last only several months. (8) In approximately 45% of carpal tunnel syndrome cases, surgery is recommended; however, one-third of these patients continue to have pain and functional impairment. (9) Post-surgical recovery is generally slow, with resumption of light work after 1 month in only 50% of patients in 1 study. (10) These results have prompted clinicians and researchers to look toward other less invasive and costly treatment modalities, including acupuncture. (11) Preliminary studies indicate that acupuncture may be an effective treatment in carpal tunnel syndrome.

A search of MEDLINE, EMBASE, and CINAHL databases found 1 randomized controlled study by Naser et al of 11 patients who had significant decreases in their McGill Pain Questionnaire score, median nerve sensory latency, and...

Source Citation

Source Citation
Schulman, Robert A., and Brian Liem. "Treatment of carpal tunnel syndrome with medical acupuncture." Medical Acupuncture, vol. 20, no. 3, Sept. 2008, pp. 163+. Accessed 29 Nov. 2021.
  

Gale Document Number: GALE|A187496586