Carpal Tunnel

Acupuncture in patients with carpal tunnel syndrome: A randomized controlled trial.

Yang CP, Hsieh CL, Wang NH, Li TC, Hwang KL, Yu SC, Chang MH.   Department of Neurology, Kuang Tien General Hospital , Taiwan .

OBJECTIVES: To investigate the efficacy of acupuncture compared with steroid treatment in patients with mild-to-moderate carpal tunnel syndrome (CTS) as measured by objective changes in nerve conduction studies (NCS) and subjective symptoms assessment in a randomized, controlled study.

METHODS: A total of 77 consecutive and prospective CTS patients confirmed by NCS were enrolled in the study. Those who had fixed sensory complaint over the median nerve and thenar muscle atrophy were excluded. The CTS patients were randomly divided into 2 treatment arms: (1) 2 weeks of prednisolone 20 mg daily followed by 2 weeks of prednisolone 10 mg daily (n = 39), and (2) acupuncture administered in 8 sessions over 4 weeks (n = 38). A validated standard questionnaire as a subjective measurement was used to rate the 5 major symptoms (pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening) on a scale from 0 (no symptoms) to 10 (very severe). The total score in each of the 5 categories was termed the global symptom score (GSS). Patients completed standard questionnaires at baseline and 2 and 4 weeks later. The changes in GSS were analyzed to evaluate the statistical significance. NCS were performed at baseline and repeated at the end of the study to assess improvement. All main analyses used intent-to-treat.

RESULTS: A total of 77 patients who fulfilled the criteria for mild-to-moderate CTS were recruited in the study. There were 38 in the acupuncture group and 39 in the steroid group. The evaluation of GSS showed that there was a high percentage of improvement in both groups at weeks 2 and 4 (P < 0.01), though statistical significance was not demonstrated between the 2 groups (P = 0.15). Of the 5 main symptoms scores (pain, numbness, paresthesia, weakness/clumsiness, nocturnal awakening), only 1, nocturnal awakening, showed a significant decrease in acupuncture compared with the steroid group at week 4 (P = 0.03). Patients with acupuncture treatment had a significant decrease in distal motor latency compared with the steroid group at week 4 (P = 0.012). Acupuncture was well tolerated with minimal adverse effects.

CONCLUSIONS: Short-term acupuncture treatment is as effective as short-term low-dose prednisolone for mild-to-moderate CTS. For those who do have an intolerance or contraindication for oral steroid or for those who do not opt for early surgery, acupuncture treatment provides an alternative choice.

Dr Kerr comments made on the Clinic Facebook page : ‪#‎Carpaltunnelsyndrome‬ (CTS) is the most prevalent form of peripheral‪#‎neuropathy‬ and this ‪#‎randomized‬ controlled trial study shows the effect of ‪#‎acupuncture‬ on this painful Syndrome.
I had this interesting story to share, a Chiropractor sent me this patient years ago to treat sciatica pain, and I helped her and she was successful in the treatment and I did not see her again, than 3 years later she came back to treat CTS ( she never mentioned before) once her doctor said her nerve conduction study (NCS) showed a SEVERE condition and she needed surgery, ( she has CTS since early 2000’S and she was suffering in pain every day and not finding anything that could relief her discomfort)
we had couple of sessions at ‪#‎prairiemedicalacupunctureclinic‬ and the results are amazing !!!!! she is pain free for many weeks, she can do house work, SHE is working full time, she can cook her meals and travel being pain free and could skip the Surgery!!! She is so grateful for acupuncture but regretted to wait 15 years to try acupuncture.