Efficacies of Acupuncture and Anti-inflammatory Treatment for Carpal Tunnel Syndrome

Carpal tunnel syndrome is the most common compressive neuropathy, causing pain, tingling, and numbness in the fingers. This Iranian study investigated whether acupuncture would be more effective than conventional anti-inflammatory treatment for mild-to-moderate cases. Fifty patients with electrodiagnostically confirmed diagnosis were randomized into two groups: one received eight acupuncture sessions (twice a week for four weeks) plus a nocturnal splint, while the control group received ibuprofen 400 mg three times a day for ten days plus a nocturnal splint. The acupuncture protocol included nine specific points on the affected side: PC-7 (Daling), PC-4 (Ximen), PC-6 (Neiguan), PC-8 (Laogong), HT-2 (Qingling), HT-7 (Shenmen), HT-8 (Shaofu), LU-9 (Taiyuan), and LI-11 (Quchi).

The needles were retained for twenty minutes with manual stimulation to elicit the Deqi sensation. Outcomes were assessed using the Visual Analogue Scale for pain, the Boston Carpal Tunnel Questionnaire (symptoms and function), and electrodiagnostic parameters. After one month, both groups showed significant improvements, but the acupuncture group had superior results. Pain reduction was more pronounced in the acupuncture group (from 7.32 to 3.8) compared with the ibuprofen group (from 7.32 to 4.64), with a statistically significant difference between groups.

The Boston Questionnaire symptom and function scores also improved more in the acupuncture group. In electrodiagnostic parameters, acupuncture produced greater improvement in nerve conduction velocity and distal sensory latency, although distal motor latency improved similarly in both groups. Clinically, patients treated with acupuncture reported fewer nocturnal awakenings due to pain or tingling, lower intensity of numbness, and better performance in activities such as using the phone and performing household chores. Importantly, no patients in the acupuncture group experienced adverse effects, whereas five patients in the ibuprofen group developed gastrointestinal effects, treated with omeprazole.

Proposed mechanisms for the efficacy of acupuncture include modulation of limbic brain activity, anti-inflammatory and immunomodulatory effects, and improved local blood supply to the median nerve. This study adds to the evidence that acupuncture can be a safe and effective alternative to conventional pharmacological treatment for mild-to-moderate carpal tunnel syndrome, offering superior symptom relief with a favorable safety profile.