Recent development in acupuncture for carpal tunnel syndrome

Acupuncture has been used to treat patients with carpal tunnel syndrome (CTS) for improving symptoms such pain, numbness, preventing local muscle atrophy and regaining the function. Advantages of acupuncture over other treatments such as nonsteroidal anti-inflammatory drugs, local corticosteroid injection and surgical procedures have been gradually recognized. Here is the summary of recent reports of acupuncture treatments for CTS.

Recently Maeda et al., (2017) conducted a blinded; placebo controlled and randomized clinical study to assess changes in symptoms, neurophysiologic and brain neuronal activities between verum acupuncture and sham acupuncture treatments.

It was found that while both verum and sham acupuncture reduced CTS symptoms, verum was superior to sham in producing improvements in both peripheral and brain neurophysiological outcomes, i.e. median sensory nerve conduction latency and digits 2 and 3 cortical separation distance in the brain primary somatosensory cortex. Further, improvement in functional primary somatosensory cortical plasticity soon following acupuncture predicated the long-term symptom relief. Diffusion tensor imaging analysis of white matter microstructure found that acupuncture at local versus distal acupuncture sites may improve median nerve function at the wrist by mediating somatosensory neuroplasticity following therapy.

In another study, Ural and Öztürk explored the effect of acupuncture on cross-sectional area (CSA) of median nerve at the wrist in patients with CTS in a randomized clinical study. Visual analog scale (VAS), Duruoz Hand Index (DHI), Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores, electrophysiologic measurements, and median nerve CSAs were measured before and after the treatment in both acupuncture and splinting only groups. Although VAS, DHI, Quick Disabilities of the Arm, DASH questionnaire scores, electrophysiologic measurements were improved in both groups, only acupuncture reduced CSAs, indicating anti-inflammatory effect by acupuncture.

Results from the studies indicate that acupuncture may improve CTS pathophysiology by both local and brain-based mechanisms involving somatosensory cortical neuroplasticity.

References:

Maeda Y et al., Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture. Brain. 2017 Apr 1;140(4):914-927. doi: 10.1093/brain/awx015.   https://www.ncbi.nlm.nih.gov/pubmed/28334999
Ural FG & Öztürk GT, The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study. Evidence-Based Complementary and Alternative Medicine, Volume 2017 (2017), Article ID 7420648, 5 pages.   https://www.hindawi.com/journals/ecam/2017/7420648/ 

Abdominal acupuncture is very effective in treating neck pain

Abdominal acupuncture was used to treat patients with neck pain. It was shown that abdominal acupuncture significantly improved the symptoms compared with sham acupuncture. The study was recently published in the journal of PLOS one.

Neck pain is a common medical condition, coming from a number of disorders and can involve any of tissues in the neck. For example, neck pain can come from the conditions directly affecting the muscles of the neck, e.g. fibromyalgia. Symptoms of neck pain can range from stiff neck, sharp stabling pain on one spot, tenderness or soreness on a general area, and pain that radiates down into the shoulders, arms or fingers; or radiates up into the head. Chronic neck pain is reported to severely affect people’s daily life and downgrade the quality of life. Conventional treatments such as pain relieves tablets is only temporary solution. The cause treatments for many cases are more complicated.

Abdominal acupuncture is a new form of acupuncture technique, based on traditional Chinese acupuncture meridian theory and developed by Dr. Zhiyun Bo in 1991. Since then it has been used to effectively treat various conditions including pain and neurological disorders.

Recently a randomized, double-blinded and sham controlled clinical trial of effect of abdominal acupuncture on chronic pain was conducted with 154 subjects, divided into abdominal acupuncture group (AAG, n=77) and sham acupuncture group (SAG, n=77). The patients in AAG received acupuncture on acupoints, CV12, CV4, bilateral KI17 and ST24 for 30 min each session, three times a week for two weeks. The primary outcome included mean improvement in neck pain disability scores evaluated by the Northwick Park Neck Pain Questionnaire (NPQ). Secondary outcomes included intensity of neck pain and health-related quality-of-life measures. The outcomes were monitored at baseline and at 2 and 6 weeks from baseline. Patients in the AAG received additional follow-up assessment at 14 weeks from baseline.

Results showed that patients in AAG showed significantly improvement in NPQ scores at both 2 and 6 weeks compared with those of SAG and the improvement was maintained at 14-week follow up. The secondary outcome measures in AAG were markedly improved compared with SAG.

The study showed that abdominal acupuncture is a very effective alternative treatment for people with neck pain.

Reference:

Ho LF, et al., Efficacy of abdominal acupuncture for neck pain: A randomized controlled trial. PLoS One. 2017 Jul 17;12(7):e0181360. doi: 10.1371/journal.pone.0181360.    https://www.ncbi.nlm.nih.gov/pubmed/28715459