Clinical Effectiveness of Acupuncture for Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the most common compression neuropathy of the upper limbs, characterized by compression of the median nerve at the wrist. This clinical study investigated the comparative efficacy of manual acupuncture versus electroacupuncture in the treatment of CTS, a condition that affects millions of people worldwide and can cause pain, numbness, tingling, and weakness in the hands.

Researchers from China Medical University in Taiwan conducted a controlled trial with 26 patients diagnosed with CTS through electrodiagnostic studies. Participants were divided into two groups: 15 received manual acupuncture and 11 received electroacupuncture. Both groups were treated at points PC-7 (Daling) and PC-6 (Neiguan) of the pericardium meridian, located along the course of the median nerve in both arms. The treatment protocol consisted of 24 sessions of 15 minutes each, applied over 6 weeks with a frequency of 4 sessions per week.

The methodology included comprehensive assessments before and after treatment, using symptom severity questionnaires, grip and pinch strength tests, electrophysiologic studies, and physical provocation tests such as the Tinel sign. For electroacupuncture, an electrical current of 0.8 mA at a frequency of 2 Hz was applied between points PC-7 and PC-6.

The results revealed that both treatment modalities produced benefits, but with distinct efficacy profiles. Electroacupuncture was superior in reducing symptom severity, with statistically significant improvement (p = 0.02) in Lo and Chiang questionnaire scores. On the other hand, manual acupuncture demonstrated more pronounced effects on functional and neurophysiologic measures. Specifically, the manual acupuncture group showed a significant increase in grip strength on the more symptomatic side (from 23.3 to 27.9 kg, p = 0.01), improvement in distal motor amplitude of the median nerve (from 6.5 to 7.6 mV, p = 0.02), and a significant reduction in palm-wrist sensory latency.

Electrophysiologic assessments showed that manual acupuncture promoted important improvements in nerve conduction, including a reduction in mean F-wave latency of the median nerve (p = 0.002) and an increase in F-wave persistence (p = 0.04), indicating recovery of nerve function. In addition, there was a significant reduction in Tinel sign positivity, from 46.7% to 20.0% (p = 0.046), suggesting decreased irritability of the median nerve.

This study contributes to the understanding that acupuncture and electroacupuncture may offer valuable complementary approaches for the conservative treatment of CTS. The findings suggest that the choice between modalities can be individualized based on specific therapeutic goals: electroacupuncture for symptomatic relief and manual acupuncture for functional and neurophysiologic recovery. The use of specific points of the pericardium meridian, anatomically related to the course of the median nerve, proved to be a rational and effective strategy. The results support the inclusion of these techniques as nonsurgical therapeutic options for patients with CTS, especially considering the favorable safety profile observed in the study.