2023 Frontiers in Neuroscience

Acupuncture's effectiveness for carpal tunnel syndrome uncovers better pain relief compared to night splints and potential benefits when used alongside other treatments

Acupuncture was found to be more effective than night splints for pain relief, but no differences were observed in symptom severity and functional status. When used alongside other treatments, acupuncture showed potential in improving various CTS factors. However, the evidence quality was generally low or very low.

Acupuncture for carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials Dong Q, Li X, Yuan P, Chen G, Li J, Deng J, Wu F, Yang Y, Fu H, Jin R

2022 Journal of Acupuncture Research

Electroacupuncture treatment for carpal tunnel syndrome was reported to be effective and showed a significant difference from the control group.

Although electroacupuncture treatment for carpal tunnel syndrome was reported to be effective and showed a significant difference from the control group, in some evaluation items no significant differences were observed. The quality and the number of studies included in this review was limiting, therefore an accurate evaluation of the efficacy of electroacupuncture treatment for CTS was not possible.

Electroacupuncture for Carpal Tunnel Syndrome: A Review of Randomized Controlled Trials Park CW, Lim MJ, Lee SW, Yi YH, Song DW, Yu SG, Kim MJ, Oh DY, Choi HJ, Ju AR

2022 Medical Acupuncture

Acupuncture may be effective and safe for short-term pain reduction and functional improvement in hand-and-wrist conditions.

In the 10 included RCTs (622 participants), 6 had a low risk of bias. For cryotherapy-induced pain, 1 trial showed significant pain reduction post treatment. For rheumatoid arthritis, 1 trial shown significant pain reduction and function improvements post treatment and short-term. For carpal tunnel syndrome, 1 trial showed significant pain reduction and functional improvements intermediate-term, while 3 trials suggested no significant difference. For tenosynovitis, 1 trial showed significant pain reduction and function improvements short-term. For poststroke impairments, 1 trial showed significant function improvements post treatment and at short-term, while another trial suggested no significant difference. No significant improvements were noted for trapezio-metacarpal joint osteoarthritis. In 2 trials, adverse effects occurred in patients with carpal tunnel syndrome; yet acupuncture appeared to be relatively safe.

The Effect of Acupuncture on Hand and Wrist Pain Intensity, Functional Status, and Quality of Life in Adults: A Systematic Review Trinh K, Zhou F, Belski N, Deng J, Wong CY

2021 Journal of Pharmacopuncture

Acupuncture can be used for carpal tunnel syndrome treatment without serious adverse effects.

In the selected papers, several measurement tools measured the post-treatment improvement of patients and, in most cases, a comparison of the acupuncture and control groups showed that acupuncture treatment was significantly more effective than the comparator intervention. Thus, acupuncture treatment was positively evaluated with regard to efficacy for mild-to-moderate carpal tunnel syndrome.

Effect of Manual Acupuncture for Mild-to-Moderate Carpal Tunnel Syndrome: A Systematic Review Huh JH, Jeong HI, Kim KH

2020 Neuropediatrics

Acupuncture and electroacupuncture are a therapeutic option for mild to moderate carpal tunnel syndrome with a medium level of scientific evidence, tending towards a high level, and with a medium level of recommendation.

The search retrieved 698 articles in total. After applying the inclusion and exclusion criteria, 21 articles were included. The level of evidence of all the articles was medium-high. The level of recommendation was medium, and the risk of bias was neutral, with a tendency towards low bias. The articles included revealed symptomatic and neurophysiological improvements, both peripheral as well as central, due to the cerebral response that occurs associated with the function of the median nerve.

Acupuncture and electroacupuncture in the treatment of carpal tunnel syndrome: Systematic review Badia M, Santafé MM

2019 Clinical Rehabilitation

For both symptom relief and function improvement, manual acupuncture is superior to ibuprofen for carpal tunnel syndrome.

Result of this systematic review has shown that acupuncture and related therapies appear to be effective in improving symptoms, function and pain in carpal tunnel syndrome.

However, validity of such conclusion is limited as majority of the included trials are at high risk of bias from lack of blinding.

Associated adverse events were minimal.

Acupuncture and related interventions for carpal tunnel syndrome: systematic review Wu IXY, Lam VCK, Ho RST, Cheung WKW, Sit RWS, Chou LW, Zhang Y, Leung TH, Chung VCH

2019 Timisoara Physical Education and Rehabilitation Journal

The results of manual, traditional and non-invasive therapies are similar to those of surgical treatments, and even better in a very large number of cases.

In the current context of medicine and therapy, statistics indicate a tendency to approach the carpal tunnel syndrome by surgical treatment, to the detriment of approaching the pathology through a non-invasive technique. The relevant specialized articles selected for this study, and published in the past 10 years, prove that alternative medicine, physical therapy, electrotherapy, and the natural evolution of untreated patients or of patients exposed to the placebo effect, may significantly improve the symptoms of the carpal tunnel syndrome.

Systematic review of treatment methods for the carpal tunnel syndrome Glazer C, Pantea C

2017 Evidence-Based Complementary and Alternative Medicine

Acupuncture therapy can lead to both clinical and morphological improvements in patients with carpal tunnel syndrome.

In this study, 27 female patients suffering from carpal tunnel syndrome were divided into two groups: one that used only a night wrist splint and another that received additional acupuncture therapy. The measurements were taken from 45 limbs and included a visual analogue scale, the Duruöz Hand Index, and the Quick Disabilities of the Arm, Shoulder and Hand questionnaire scores. In addition, electrophysiological measurements and observation of the median nerve's cross-sectional area were taken before and after the treatment.

Following the treatment, improvements were observed in both groups according to the visual analogue scale, the Duruöz Hand Index and Quick Disabilities of the Arm, Shoulder and Hand questionnaire scores, and the electrophysiological measurements. However, a significant decrease was noted solely in the cross-sectional area of the median nerve in the acupuncture group, while the control group that only used the wrist splint showed no changes. Thus, it was concluded that acupuncture therapy provided both clinical and morphological benefits to patients with carpal tunnel syndrome.

The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study Ural FG, Öztürk GT

2016 Journal of Orthopaedic & Sports Physical Therapy

Acupuncture, specifically needle-based and electroacupuncture, can potentially provide therapeutic benefits for carpal tunnel syndrome, Achilles tendinopathy, and shoulder injuries.

Methodology: The researchers executed a systematic review on multiple databases such as MEDLINE, Embase, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials covering a period from 1990 to 2015. Their search was focused on identifying responsive randomized controlled trials, cohort studies, and case-control studies which focused on the effectiveness and safety of acupuncture therapies for musculoskeletal disorders. The Scottish Intercollegiate Guidelines Network criteria was used to evaluate the eligible studies. Furthermore, best-evidence synthesis was performed to sum up results from studies with low bias risk. A sensitivity analysis was also performed to comprehend the potential impact of excluding studies with high bias risk.

Results: The comprehensive review identified 5180 articles, from which 15 were selected for final analysis (10 had a low risk of bias and 5 with a high risk of bias). Among other findings, the results showed that traditional needle acupuncture may outperform oral steroids and vitamin B1/B6 supplements for carpal tunnel syndrome and exercises for Achilles tendinopathy. Moreover, electroacupuncture might be superior than placebo for shoulder injuries. The extent of benefits offered by dry needling for plantar fasciitis remained equivocal. Traditional needle acupuncture didn't show significant advantage over placebo for upper extremity pain, or no intervention for patellofemoral pain, and findings for shoulder pain were inconclusive.

Effectiveness of Acupuncture Therapies to Manage Musculoskeletal Disorders of the Extremities: A Systematic Review Cox, J., Varatharajan, S., Côté, P., & Optima Collaboration

2015 Neurology

The majority of trials demonstrate a positive effect of acupuncture over control condition in the treatment of neuropathy.

The majority of RCTs reviewed showed clear benefit for acupuncture over control in the treatment of diabetic neuropathy, Bell’s palsy and carpal tunnel syndrome. Acupuncture is probably effective in the treatment of HIV-related neuropathy and there is insufficient evidence for its benefits in idiopathic neuropathy. Meta-analyses of all diabetic neuropathy and bell’s palsy data using a summary estimate random effects model showed combined Odds Ratio (OR) of 4.23, p<0.001 favoring acupuncture over control for pain outcomes. The majority of trials demonstrate a positive effect of acupuncture over control condition in the treatment of neuropathy. Further more rigorously designed studies are needed to better characterize this effect.

Effects of Acupuncture on Neuropathic Pain: A Systematic Review and Meta-analysis Alexandra Dimitrova, Charles Murchison, Barry Oken

2014 The American Journal of Chinese Medicine

Acupuncture and electroacupuncture treatments can alleviate Carpal Tunnel Syndrome symptoms, enhance nerve repair and improve sensory and motor functions.

The conducted research involved treating 26 confirmed Carpal Tunnel Syndrome patients using acupuncture and electroacupuncture. These patients were divided into two treatment groups based on a neurophysiological grading scale. Fifteen patients were treated with acupuncture and eleven with electroacupuncture, which was administered on both upper limbs at acupoints PC-7 (Daling) and PC-6 (Neiguan) along the pericardial meridian. Each patient underwent a total of 24 treatment sessions lasting 15 minutes each, spread over a period of six weeks.

Evaluation of the results saw improvements in symptom severity after the electroacupuncture treatments. This was based on the short clinical questionnaire by Lo and Chiang, an evaluation method used to gauge symptom severity. Post acupuncture treatment, the patients reported a significant increase in grip strength, particularly on the side more affected by Carpal Tunnel Syndrome. The electrophysiology evaluation also saw a significant improvement in the motor amplitude of the palm-wrist segment. There was also a notable decrease in Tinel's sign on the side more affected by symptoms. This points to both acupuncture and electroacupuncture having clear therapeutic benefits for Carpal Tunnel Syndrome patients.

Clinical Effectiveness of Acupuncture for Carpal Tunnel Syndrome Ho CY, Lin HC, Lee YC, Chou LW, Kuo TW, Chang HW, Chen YS, Lo SF

2010 The Journal of Pain

A meta-analysis of acupuncture versus steroid block therapy favored acupuncture in terms of responder rate.

Our systematic review and meta-analysis demonstrate that the evidence for acupuncture as a symptomatic therapy of carpal tunnel syndrome is encouraging but not convincing. The total number of included RCTs and their methodological quality were low. Further rigorous studies are required to establish whether acupuncture has therapeutic value for this indication.

Acupuncture for Carpal Tunnel Syndrome: A Systematic Review of Randomized Controlled Trials Lee, H., Shim, H., Shin, B., Jung, A., Lee, M., & Ernst, E.