What is carpal tunnel syndrome?

The carpal tunnel is a narrow canal in the wrist surrounded by bone and ligaments. The tendons that allow the fingers to bend pass through this space, along with the median nerve, which creates feeling for all fingers except the pinky and helps control muscles at the base of the thumb.¹

Carpal tunnel syndrome occurs when the median nerve is compressed, or squeezed, inside the carpal tunnel.

Symptoms

Weakness, pain, numbness, and tingling in the hand are the hallmarks of carpal tunnel syndrome. Often pain radiates into the wrist and forearm as well.

Symptoms progress over time if the condition isn't treated. In advanced carpal tunnel syndrome, people may have difficulty picking up small items or drop objects because of reduced grip strength. They may experience constant numbness in their fingers and lose the ability to distinguish between hot and cold by feel.²

Causes of Carpal Tunnel Syndrome

Because the carpal tunnel is rigid and narrow, it is an area of the body especially susceptible to nerve compression if any condition reduces the space available for the median nerve within it. This can be caused by acute or overuse injuries and health conditions that cause swelling and inflammation affecting the ligaments of the carpal tunnel or the median nerve itself.³

Arthritis, diabetes, obesity, hormone imbalances, fluid retention during pregnancy, acute injuries like a broken or sprained wrist, and repetitive stress from fine hand movements are all associated with carpal tunnel syndrome. Gender and heredity may play a factor as well. Some people, especially women, are born with narrower carpal tunnels, making them more vulnerable to carpal tunnel syndrome.⁴

The symptoms may be especially severe at night or in the morning since most people sleep with flexed wrists. People can experience carpal tunnel syndrome in one or both hands; often, symptoms show up first or are more severe in the dominant hand.

Diagnosis

Diagnosis of carpal tunnel syndrome is made by examining the muscles and nerves for damage and weakness and through imagery that looks for nerve compression. Tests can include specific physical evaluations by your doctor, a nerve conduction test, ultrasound, and other imaging.

Typical treatment options

In its early stages, carpal tunnel syndrome can sometimes be eased through the use of a wrist brace or splint, either during daytime, overnight, or both; however, this can also interfere with functioning.

If activities are a major contributor to the condition, avoiding those tasks or taking regular breaks can help. Ice packs can help reduce inflammation. Over-the-counter medicines like nonsteroidal anti-inflammatory medication and other pain relievers can help manage symptoms. Sometimes stretching and strength training exercises can be beneficial.

Improving biomechanics during activities that exacerbate the condition can aid in prevention, such as adjusting the wrist position while typing or using ergonomically designed office equipment like wrist supports and specially designed keyboards.

If the condition doesn't improve with these measures, prescription drugs may be used, including prednisone and lidocaine. Cortisone injections can provide powerful but temporary relief. Prescription measures in particular can carry risk of side effects and can complicate other health conditions.

Carpal tunnel release surgery is used in severe cases of carpal tunnel syndrome. This surgery involves cutting a ligament that forms part of the carpal tunnel to relieve pressure on the median nerve.

People with long untreated or severe carpal tunnel syndrome can experience permanent nerve damage.

Increasingly, conventional health care providers are supporting the use of acupuncture as a first-line treatment for carpal tunnel syndrome, especially in early stages of the condition before higher-risk treatments are used.

Acupuncture is low risk and low cost. Mounting evidence of its efficacy through clinical trials is causing this healing art to gain broader acceptance in the mainstream medical community as a prudent early treatment option.

A lead author of a 2017 study⁵ noted in discussion with the New York Times,⁶ acupuncture is "perfect for a first-line approach, and it's something patients should consider before trying more invasive procedures like surgery".

How acupuncture can help

What is acupuncture?

Acupuncture is a central healing art within Traditional Chinese Medicine, renowned for its ability to stimulate the body's own healing powers.

A typical acupuncture session involves the insertion of between five and twenty very fine, sterilized needles into the skin in strategic locations on the body. The acupuncturist may briefly, gently twirl or otherwise manipulate the needles after insertion. The patient is then left to rest for ten or twenty minutes and then the needles are removed.

For most people, the process involves minimal discomfort - perhaps some temporary soreness. Many people describe feeling relaxed or refreshed and invigorated following acupuncture treatment.

How does acupuncture treat carpal tunnel syndrome?

According to Traditional Chinese Medicine, the strong, free flow of qi is crucial to the functioning of all living beings. Qi is a vital energy that circulates in and around the body through pathways known as meridians.

Mental and physical stress and trauma can lead to blockages and weakening of qi. When energy flows are impeded, imbalances can occur, gradually making the body less resilient and more vulnerable to illness. Acupuncture works by rebalancing the body's flow of qi and thereby supporting its own natural self-healing ability.

Acupuncture treatment for carpal tunnel syndrome varies according to the acupuncturist and specific patient condition, but tends to include needle placements intended to stimulate the flow of blood and energy and overall healing and the reduction of tension in the wrist, arm, and hand.⁷

A series of regular treatments is standard in acupuncture and seen as most effective. One or more treatments each week for four to eight weeks is common.

Scientific evidence for acupuncture as a carpal tunnel treatment

Empirical medical researchers increasingly exploring the physiological impacts of acupuncture treatment believe it may stimulate the body's nervous system, causing it to release a variety of substances helpful in alleviating pain, boosting feelings of wellness and contributing to physical recovery: immune system cells, endorphins, neurotransmitters, hormones and more.⁸ Studies have also shown acupuncture impacts body temperature and blood circulation.

Clinical studies show that the impacts are in full effect when acupuncture is used to treat carpal tunnel syndrome.

The 2017 study published in the journal Brain and mentioned above found that acupuncture improved objective measures of nerve conduction in the wrist and reduced symptoms of pain and numbness. Brain MRIs showed long-term "remapping" of patients: somatosensory cortices that had suffered damage as a result of carpal tunnel syndrome.⁹

A 2014 Chinese study showed improved nerve and hand function, improved grip strength, and reduced symptoms when carpal tunnel syndrome sufferers were treated with acupuncture.¹⁰ A 2018 study by Chinese researchers came to similar conclusions, finding that acupuncture treatment "successfully alleviates pain, inflammation, numbness, and restores motor dexterity" in carpal tunnel syndrome patients.¹¹

Acupuncture, which is regulated for safety in the United States by the Food and Drug Administration, is widely regarded as safe. It is generally far less costly as well as less risky than many conventional medical treatments such as cortisone injections or surgery.

As this powerful therapy's efficacy is increasingly explored and well-documented by scientific researchers, these factors are contributing to acupuncture's rising popularity as a first-line treatment option for carpal tunnel syndrome, as well as a wide array of other health conditions.

References:

¹ "Carpal Tunnel Syndrome": https://orthoinfo.aaos.org/en/diseases--conditions/carpal-tunnel-syndrome/

² "Carpal Tunnel Syndrome Fact Sheet": https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-sheet

³ "Carpal tunnel syndrome: Symptoms, diagnosis, treatment, and prevention": https://www.health.harvard.edu/pain/carpal-tunnel-syndrome

⁴ "Carpal Tunnel Syndrome Fact Sheet": https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-sheet

⁵ "Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture": https://academic.oup.com/brain/article/140/4/914/3058778

⁶ "Acupuncture Can Ease Wrist Pain of Carpal Tunnel Syndrome": https://www.nytimes.com/2017/03/02/well/live/acupuncture-can-ease-wrist-pain-of-carpal-tunnel-syndrome.html

⁷ "Acupuncture Stops Carpal Tunnel Wrist Pain, Restores Dexterity": https://www.nccaom.org/wp-content/uploads/pdf/Acupuncture%20Stops%20Carpal%20Tunnel%20Wrist%20Pain,%20Restores%20Dexterity.pdf

⁸ "Acupuncture": https://www.health.harvard.edu/medical-tests-and-procedures/acupuncture-a-to-z

⁹ "The Weird Way Acupuncture Helps Carpal Tunnel Syndrome": https://time.com/4690200/acupuncture-carpal-tunnel-syndrome/

¹⁰ "Clinical effectiveness of acupuncture for carpal tunnel syndrome": https://www.ncbi.nlm.nih.gov/pubmed/24707864

¹¹ "Acupuncture Stops Carpal Tunnel Wrist Pain, Restores Dexterity": https://www.nccaom.org/wp-content/uploads/pdf/Acupuncture%20Stops%20Carpal%20Tunnel%20Wrist%20Pain,%20Restores%20Dexterity.pdf