Did you know acupuncture is effective treatment for carpal tunnel syndrome? In addition to the over three-thousand year history of acupuncture strategies to address multiple pain syndromes such as Carpal Tunnel, a study in the Clinical Journal of Pain shows acupuncture is as effective as prednisone for the symptoms of the syndrome including pain, nighttime waking, numbness, tingling, and weakness. Additionally, acupuncture is an excellent option for those intolerant of steroidal therapy, commonly prescribed to treat the syndrome as well. In both patients’ motor function and frequency of pain awakening them at night, the acupuncture group had better results than those receiving steroidal therapy (1).
Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm to the hand, becomes compressed or squeezed at the wrist. The bottom and sides of this tunnel are formed by wrist (carpal) bones, which are between the arm bones (ulna and radius) and the metacarpals (bases of the fingers). The top of the tunnel is covered by a strong band of connective tissue called the transverse carpal ligament, located on the underside or dorsum of the wrist.
This already narrow tunnel houses both the finger flexor tendons that bend the finger, and the median nerve which provides feeling and movement to the “thumb side” of the hand (the palm, thumb, index finger, middle finger, and thumb side of the ring finger).
Usually symptoms of numbness, weak hand grip, pain, a pins-and-needles sensation from the wrist to the thumb, index, middle, or ring finger appear gradually and worsen over time, leading to near constant pain that often awakens the individual from sleep.
Carpal tunnel syndrome commonly effects those engaged in fine motor work and repetitive motion with the hands such as typing. The condition occurs most often in people 30 to 60 years old, and is more common in women than men. Heredity can be a factor as well since carpal tunnels are smaller in some people, and this trait can run in families. Hormonal changes related to pregnancy can play a role, as can medical conditions including diabetes, rheumatoid arthritis, and thyroid gland imbalance.
An acupuncture treatment plan for acute carpal tunnel typically includes bi-weekly acupuncture treatments for the first two or three weeks to gain significant momentum, and then once a week with varying duration.
In additional to acupuncture therapy, taking a supplement of Bromelain for inflammation (250-750 mg 2x day between meals) and vitamin B6 (25mg) plus B2 (10mg 3-4x day) is helpful. Bromelain is found naturally in pineapple and is an anti-inflammatory enzyme. Omega 3 fatty acids also reduce inflammation and are an important part of a healthy diet, found in some vegetable oils, such as soybean, rapeseed (canola), and flaxseed, and in walnuts sardines,brussels sprouts, kale and spinach.
Stretching the wrists several times a day is recommended to relieve symptoms and is shown to reduce the need for surgery by 50% (2). See below an example of some stretches.
Carpal Tunnel Stretches
The stretches outlined below should be done 2-4 times a day. Keep in mind with all stretching that stretches do not have to be static, fixed poses and should not be painful. Some fluidity and looseness is best, slowly releasing and then returning to a point of gentle tension throughout the 15- 30 second stretch. These stretches may recreate your symptoms, so be gentle, but they will also eventually reduce your symptoms greatly.
Stop sign stretch
a. Extend and stretch both wrists and fingers fully, palms facing away from you and arms parallel to ground, elbows straight, pressing gently on the 4 fingers and thumb with the opposite hand. Hold for a count of 5.
Reverse Stop Sign stretch
a. Extend one arm in front of you with palm down.
b. Bend your wrist, pointing your fingers toward the floor, palm towards your body.
c. With the other hand, gently press on the back of your wrist, pressing fingers towards your body until you feel a mild to moderate stretch in your forearm and wrist.
d. Hold for 15 to 30 seconds and repeat 2 to 4 times.
Prayer Stretch
a. Start with your palms together in front of your chest just below your chin, elbows to sides and parallel to the ground.
b. Slowly lower your hands toward your waistline, keeping your hands close to your stomach and your palms together, until you feel a mild to moderate stretch under your forearms and wrists.
c. Hold gently for 15 – 30 seconds and repeat 2 to 4 times.
Reverse Prayer Stretch
a. With arms in the same position, flip your palms so the the backs of your hands are pressed gently together from fingers to about an inch distal to the wrist joint.
b. Press gently until you feel a moderate stretch.
c. Hold for 15-30 seconds, repeat 2-4 times.
Superman Stretch
a. Straighten both arms and wrists and relax fingers with arms out in front of you parallel to the ground.
c. Arms still outstretched, make a tight fist with both hands, then bend both wrists down while keeping the fist. Hold for a count of 5.
Check here for other images of some helpful, yet simple, stretches for Carpal Tunnel Syndrome: http://journals.lww.com/clinicalpain/toc/2009/05000.
Resources:
1. The Clinical Journal of Pain. 25(4):327-333, May 2009.doi: 10.1097/AJP.0b013e318190511c
2. According to the Encyclopedia of Natural Medicine, 1998.
3. Clin J Pain. 2009 May;25(4):327-33. doi: 10.1097/AJP.0b013e318190511c.; “Acupuncture in patients with carpal tunnel syndrome: A randomized controlled trial.” Yang CP, Hsieh CL, Wang NH, Li TC, Hwang KL, Yu SC, Chang MH. http://www.ncbi.nlm.nih.gov/pubmed/19590482
