Acupuncture Stops Carpal Tunnel Wrist Pain, Restores Dexterity

Acupuncture Stops Carpal Tunnel Wrist Pain, Restores Dexterity - Northfield Clinic, Texarkana

Acupuncture is an effective treatment modality for patients with carpal tunnel syndrome. Independent investigations confirm that acupuncture is more effective than usual care, including anti-inflammatory medications. Acupuncture successfully alleviates pain, inflammation, numbness, and restores motor dexterity. Electromyography confirms the results, including improvements across multiple parameters (e.g., median nerve sensory latency, sensory nerve conduction velocity, sensory amplitude, motor latency, motor nerve conduction velocity, motor amplitude).

About Carpal Tunnel
The carpal tunnel is a canal connecting the forearm and hand. Carpal tunnel syndrome pain and numbness is due to compression of the median nerve traveling through the canal. Researchers demonstrate that acupuncture benefits the median nerve and alleviates pain. Usual care for late-stage carpal tunnel syndrome (CTS) often includes surgery. Usual care treatment for early to mid-stage CTS typically involves pharmaceutical medications, physical therapy; or alternatively, acupuncture and tui na massage. [1–3]

Early diagnosis and intervention is crucial in mitigating median nerve damage and restoring nerve function. [4–5] Carpal tunnel braces may be used to relieve CTS symptoms, but may encumber patients by limiting hand movements. Acupuncture therapy preserves freedom of movement because braces are unnecessary. Acupuncture alleviates median nerve compression, in part, by reducing edema and accelerating axonal regeneration. [6] The axon is the lengthy threadlike part of a nerve cell carrying impulses. Additional research confirms that paraffin wraps combined with Traditional Chinese Medicine (TCM) herbs also promotes clinical improvements. [7]

Research teams provide a general overview of acupuncture for the treatment of CTS in their discussions. TCM differential diagnostic categories for carpal tunnel syndrome include wind-invasion of the muscles, cold-dampness affecting the ligaments, or qi and blood stasis blocking the channels. Local acupoint selections are commonly implemented to enhance the microcirculation of blood to the median nerve and carpal tunnel. The treatment principle is to restore the flow of qi and blood to the area, relieve pressure, promote regeneration, dredge the channels, and reduce tension. Common acupoints recommended for the treatment of CTS include the following:

  • Daling (PC7)
  • Neiguan (PC6)
  • Yangxi (LI5)
  • Hegu (LI4)
  • Waiguan (TB5)

Affiliated Hospital of Liaoning TCM University
Researchers Wang Ye and Bai Yichen from the Affiliated Hospital of Liaoning Traditional Chinese Medicine University find acupuncture combined with herbal-paraffin treatment more effective than diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). [8] In a 16-week clinical trial, two patient groups were compared. One group received acupuncture and herbal-paraffin treatment, the other received topical diclofenac. The results highlight that acupuncture with herbal-paraffin treatment produces greater pain relief and restoration of wrist function than a topical NSAID.

Treatment efficacy was evaluated on two levels: pain intensity and wrist function. The Numeric Pain Rating Scale (NRS), an 11-point numeric scale, was used to quantify pain intensity. In the NRS, the patient selects an integer from 0 to 10 (0 represents no pain and 10 represents maximum pain). Based on the NRS scores, pain reduction after treatment was calculated as a percentage using the following formula: [(pre-treatment NRS score)–(post-treatment NRS score)] / [pre-treatment NRS score] * 100%. Pain reduction efficacy for each patient was categorized into 1 of 2 tiers based on these percentages:

  • Effective: NRS pain reduction percentage ≥50%.
  • Ineffective: NRS pain reduction percentage <50%.

The pain reduction effective rate for each group was derived with the following formula: [Effective] / [Total number of patients in group] * 100%. Wrist function treatment efficacy was evaluated in accordance with “Guiding Principles for Clinical Study of New Chinese Medicines.” Based on clinical symptoms after treatment, the wrist function treatment efficacy for each patient was categorized into 1 of 4 tiers:

  • Clinical recovery: Absence of hand numbness and wrist stiffness/weakness. Forearm able to function normally.
  • Significantly effective: Hand numbness and wrist stiffness/weakness mostly alleviated. Forearm mostly able to function normally, albeit slight discomfort after intense movement/exertion.
  • Effective: Hand numbness and wrist stiffness/weakness alleviated, but slight pain/discomfort persists. Or relapse within 6 months after clinical recovery.
  • Ineffective: No improvement, or worsening, of hand numbness and wrist stiffness/weakness. [9]

Results
The wrist function treatment effective rate for each group was derived with the following formula: [Clinical recovery + Significantly effective + Effective] / [Total number of patients in group] * 100%. The acupuncture with paraffin treatment group recorded a 90% pain reduction effective rate and an 85% wrist function treatment effective rate. On the other hand, the diclofenac group recorded a 65% pain reduction effective rate and a 50% wrist function treatment effective rate. The data shows a marked difference (P<0.05) in performance between acupuncture with herbal-paraffin and diclofenac, in both pain reduction and wrist function recovery outcomes.