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ACUPUNCTURE EFFICACY IN TREATING ADVANCED CARPAL TUNNEL SYNDROME.

Department of Anesthesia, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, Saskatchewan, S7N 0W8.

INTRODUCTION

In 1997, a National Institutes of Health Consensus Conference concluded that acupuncture (AP) might be effective as an adjunct therapy, acceptable alternative or be considered part of a comprehensive treatment program for carpal tunnel syndrome (CTS)¹. However, only 2 of 2302 citations in the primary bibliographic source commented on AP utility for CTS^2,3. The purpose of this ongoing RCT is to determine the efficacy of needle AP for the treatment of advanced carpal tunnel syndrome.

METHODS

Following IRB approval and informed consent, patients referred for surgical management of advanced CTS were randomly assigned to receive conservative Medical Therapy (MT) or Acupuncture (AP) for 6 weeks. Serum TSH, B12, folate, and HbA1c were determined for all patients at enrolment. Medical exclusion criteria included undiagnosed, untreated or uncontrolled diabetes, hypothyroidism or B12 deficiency. Pre- and post- treatment assignment, all patients completed a symptom questionnaire, nerve conduction studies and high-resolution soft tissue sonography of both wrists. MT included Naprosyn 500 mg BID, Vitamin B6 100 mg OD, custom made volar wrist splints and advice on exercise and activity modification. AP included weekly treatments using standard AP points.

RESULTS

25 patients have been enrolled to date, with 5 meeting medical exclusion criteria. All MT (n = 7) failed therapy, resulting in surgery. All AP (N = 9) have experienced improvement, resulting in cancellation of surgery after six acupuncture treatments. There was no statistical difference in nerve conduction studies or ultrasound appearance of the median nerve in either group.

DISCUSSION

This ongoing study suggests that AP may be an effective treatment for advanced CTS leading to the avoidance of surgery. Continued patient follow-up to determine the duration of symptom relief is currently ongoing. The lack of significant nerve conduction or ultrasound changes despite dramatic clinical improvement requires further investigation.

REFERENCES

1 NIH Consens Statement 1-34, 1997;

2 Neurology 46 Suppl 2:A282, 1996; [Free Full Text]

3 Am J Acupunct 18: 5-9,1990.

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