Effect of Manual Acupuncture for Mild-to-Moderate Carpal Tunnel Syndrome: A Systematic Review

Abstract

Objectives Despite the low cost and high accessibility of manual acupuncture (MA) treatments for the carpal tunnel syndrome (CTS), this intervention has not been uniformly evaluated in systematic reviews (SR), and no SR has evaluated MA monotherapy for CTS. This review was conducted to summarize the findings and undertake a quality assessment of randomized controlled trials (RCTs) of acupuncture treatment methods for mild-to-moderate CTS to identify clinical evidence for the use of MA in CTS. Methods We searched five databases for articles on relevant RCTs that were published until June 2021 without imposing specific restrictions, such as age or sex, on CTS patients. RCTs that evaluated MA were included without any restriction on comparator interventions. Measurement tools for evaluating pain reduction and functional improvement or for evaluating efficacy using electrophysiological indicators were included as outcome measures. Results We included seven RCTs, of which three studies reported both post-treatment improvement effects and statistical significance using p-values for all outcomes. Five studies reported statistically significant intergroup differences (p-values for all outcomes) in post-treatment improvement. None of the studies reported severe adverse effects of MA. In all of the RCTs, the reporting rates of the 2c, 2a, and 6a items of STRICTA 2010 were 14%, 29%, and 29%, respectively. PC7 ( Daereung ) was used to treat CTS in all of the included studies. Conclusion MA can be used for CTS treatment without serious adverse effects. PC7 was the most commonly used acupoint. In order to ensure objective and reliable reporting, accurate standardization of acupuncture treatment methods acupoint terms should be undertaken in future RCTs.

The therapeutic potential of carpal tunnel syndrome by laser acupuncture: a before-after interventional study

“…LA offers acupressure treatments that are very similar to MA, with the main difference being that LA uses a laser instead of acupuncture needles. There are many reports showing that MA is useful in the treatment of CTS without serious side effects [4]. Research Tezel et al (2019) [27] performed MA in 5 consecutive weeks at PC7 (Da ling), PC4 (Xi Men), PC6 (Nei Quan), HT7 (Shen Men), LU9 (Tai Yuan), and Ll11 (Qu Chi) and found an improvement in SSS score from 29.8 to 23.4 and FSS score from 26.8 to 20.7.…”

“…Traditional medicine therapeutic methods, including pharmacological and non-pharmacological methods, have been widely used in the treatment of CTS around the world. For patients with mild to moderate conditions, systematic assessments have demonstrated that manual acupuncture (MA) is an effective treatment without affecting the digestive system [4,5]. MA is a type of acupuncture that uses metal needles inserted into accupoints to create curing effects.…”

“…Hence, the main drawback is that MA causes pain when the needle inserts into the skin. The pain can be increased by inserting the lower points containing the median nerves, especially the Da ling point (PC7), one of the most used points in CTS treatment by methods of acupuncture [4]. Therefore, MA may not be used in some patients with fear of needles or fear of pain.…”