Treatment commenced with patients in a sitting position, with the arms, wrists, and fingers relaxed and the palms facing downwards. After disinfection of the acupoint sites, a 0.30 mm x 40 mm disposable filiform needle was inserted into each acupoint. TB4 was pierced to a depth of 10–15 mm with the triple acupuncture technique. SI5, LI5, LI4, TB5, LU10, PC8, SI3, PC7, SI6, and Ashi points were perpendicularly needled to a depth of 10–15 mm. For Sifeng points, needles were inserted rapidly to a depth of 3–6mm and then immediately withdrawn. LI11, LI10 and PC3 were pierced to a depth of 15–25 mm. Next, 3–5 Shixuan points were selected and were needled with the bleeding technique. Shixuan (translated as 10 dispersions) acupoints are located on the fingers, 0.1 cun distal to the fingernails. Each hand has ten Shixuan acupoints.
A deqi sensation was elicited at all acupoints. A TDP (Teding Diancibo Pu) heat lamp was applied to warm the acupoints. The TDP heat lamp emits far infrared radiation (2–50 micrometers).
A needle retention time of 20 minutes was observed for each acupuncture session. On week 1, the acupuncture treatments were applied once daily for 6 consecutive days. Starting at week 2, the treatments were applied every other day. Each treatment course consisted of 6 acupuncture treatments. All patients received a total of 4 treatment courses. After treatment, the treatment efficacy for each patient was categorized into 1 of 4 tiers:
Full recovery: Complete absence of symptoms. Physical movement of the upper limbs regained completely.
Significantly effective: Absence of most symptoms. Physical movement of the upper limbs regained. Discomfort reoccurs only under strenuous exercise.
Effective: Elimination of symptoms. Pain or discomfort present.
Not effective: No improvement in symptoms.
After four courses of care, the total effective rate was 95.2% with the following breakdown of improvement tiers: 66.7% fully recovered, 19.0% significantly effective, 9.5% effective, 4.8% not effective. In Traditional Chinese Medicine, carpal tunnel syndrome (CTS) falls under the Bi Zheng class of disorders. CTS is caused by weak qi and blood circulation, blood stasis, plus tendon and muscle malnourishment. Thus, researchers selected local acupuncture points to improve qi and blood circulation, including SI5, LI5, LI4, TB5, PC8, and PC7. The researchers note that the bleeding technique was applied to Shixuan points for the relief of finger paraesthesia.
Wang et al. produced similar patient outcomes by using a different acupoint prescription. Their independent investigation was published in the Journal of Clinical Acupuncture and Moxibustion. Patients receiving acupuncture had an 86.67% total effective rate for the treatment of CTS. Primary acupoints for all patients included the following:
PC7 (Daling)
PC6 (Neiguan)
Secondary acupoints included the following:
PC5 (Jianshi)
LI4 (Hegu)
PC8 (Laogong)
The patients rested in a supine position. Upon disinfection of the acupoint sites, a 0.25 mm x 40 mm filiform acupuncture needle was inserted into the acupoints with a rapid entry speed. For PC7, a mild manual stimulation was applied until a deqi sensation was achieved. For PC6, PC5, and PC8, a moderate to strong stimulation was applied until a deqi sensation was achieved. A needle retention time of 40 minutes was observed. During needle retention, the needle was manipulated every 5 minutes. Treatment was conducted once daily for 20 consecutive days. The total effective rate was 86.67% with the following breakdown of improvement tiers: 16 cases fully recovered, 6 cases significant improvements, 4 cases slight improvements, 4 no improvements.
PC6 and PC7 are mentioned in this study as particularly helpful for the treatment of CTS. PC6 is a Luo-Connecting point on the pericardium meridian. In the Zheng Jiu Da Cheng (Compendium of Acupuncture and Moxibustion), it is said that PC6 is indicated for the treatment of “swelling and spasm of the hand which is caused by the attack of wind and heat.” PC7 is also on the the pericardium meridian. According to the Zhen Jiu Jia Yi Jing (Jia–Yi Classic of Acupuncture and Moxibustion), it is effective for “hand spasms, hemiparesis of upper limbs, as well as hand spasms with slight tendon convulsion.”
Continuing acupuncture education investigations reveal that acupuncture is clinically effective for the treatment of carpal tunnel syndrome. The research published in the journal Brain provides insight into the neurophysiological mechanisms responsible for acupuncture’s therapeutic actions. The best way for patients with carpal tunnel syndrome to learn more and receive treatment is to contact licensed acupuncturists in their area.
References
Maeda, Y., Kim, H., Kettner, N., Kim, J., Cina, S., Malatesta, C., Gerber, J., McManus, C., Ong-Sutherland, R., Mezzacappa, P. and Libby, A., 2017. Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture. Brain, 140(4), pp.914-927.
Li Q, Hou SW. Acupuncture in Treating Carpal Tunnel Syndrome: a Study of 21 Cases [J]. Shanghai Journal of Acupuncture and Moxibustion, 2015(12):1229–1229.2.
Wang W, Tang W, Chi HT et al. Acupuncture in Treating Carpal Tunnel Syndrome: a Study of 30 Cases [J]. Journal of Clinical Acupuncture and Moxibustion, 2016, 32(5):28–29.
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