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/