The carpal tunnel is located at the wrist between bones and ligaments. The median nerve passes through here from the forearm to the palm of the hand. When there is pressure on the nerve in this area symptoms can occur and the condition is called carpal tunnel syndrome.
CARPAL TUNNEL SYMPTOMS
Carpal tunnel symptoms that can arise are tingling, numbness, dull ache or pain and a burning sensation mainly in the palm, thumb and middle fingers. Pain may also radiate to the wrist, elbow and shoulder. Symptoms can be worse at night and the skin may be discoloured. There may be swelling in the area. If symptoms are persistent there may be a weakness of the basic motor functions of the hands.
CARPAL TUNNEL CAUSES
Carpal tunnel syndrome affects more women than men and can be a hereditary condition. Other causes are obesity, pregnancy, diabetes and acromegaly (increased growth hormone). Symptoms could also arise as a result of the fracture, or due to rheumatoid and osteoarthritis. Many patients report a long term repetitive over use of their hands or wrist as a cause.
CARPAL TUNNEL WESTERN MEDICINE APPROACH
A GP will question your health and symptoms and do a physical examine of your movements and observe skin changes. They may refer you to a neurologist to assess any damage to the median nerve.
Treatment offered aims to reduce the pressure on the nerve. This includes resting the wrist and elevating as much as possible. Splinting or wearing a brace, anti inflammatory medications or corticosteroids either orally or injected directly into the wrist. If symptoms persist surgery will be discussed and considered to decompress the nerve.
CARPAL TUNNEL AND CHINESE MEDICINE
When visiting an acupuncturist they will question your overall health and presenting symptoms then perform a physical exam of your movements and observe any swelling, skin changes or referred pain. A Chinese medicine diagnoses also includes taking pulses and reading the tongue. This creates a complete picture of a person’s health and aids in developing an individual treatment plan. Depending on the cause (if known) a practitioner will look at other health factors that may be contributing. This could be reviewing lifestyle and eating habits as well as addressing other health concerns presented.
In clinic I (We?)have treated many patients presenting with various symptoms and levels of discomfort. Many have said that it is worse at night and that general movement and use of the hands is compromised like picking up coffee cups or driving. Sleep is often disturbed due to waking with pain and lack of sleep can be contributing to changes in moods and energy levels. I see pregnant women who have mostly had symptoms occur in the 3rd trimester when there is more fluid in the body.
Acupuncture points can be chosen locally to the carpal tunnel on the wrist as well as other areas on the body with an aim to reduce the pressure and alleviate symptoms. After the needles are inserted the patient lays on the treatment couch with low light and relaxing music for around 20 minutes.
ACUPUNCTURE CARPAL TUNNEL OBSERVED OUTCOMES
The outcome is varied depending on how long the syndrome has been there, the severity of the condition and known cause. During a course of about 4-6 acupuncture treatments patients have reported varied results. For some a reduction in symptoms and longer periods of full relief, others complete relief and some have combined acupuncture with other options like a brace or medications.
ACUPUNCTURE CARPAL TUNNEL RESEARCH
There has been one systematic review and meta analysis that demonstrated that evidence for acupuncture as a symptomatic therapy of carpal tunnel syndrome is encouraging but not convincing. (Sim 2011)
Another research article demonstrated that short term acupuncture treatment may result in long term improvement in mild to moderate carpal tunnel syndrome. Acupuncture can be considered as an alternative therapy to other conservative treatments for those who do not opt for early surgical decompression. (Yang 2009, 2011)
In this trial electro acupuncture, a current stimulating the needle in various acupuncture points was used. The findings were electro acupuncture was as effective as night splinting in respect to overall symptoms and functions in mild to moderate carpal tunnel syndrome. However, pain was reduced more by electro acupuncture than night splinting. (Kumnerddee 2010)
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REFERENCES
(Sim 2011) http://www.jpain.org/article/S1526-5900(10)00698-X/abstract
(Yang 2011) http://www.jpain.org/article/S1526-5900(10)00738-8/abstract