Carpal Tunnel Syndrome (CTS) is a type of repetitive strain injury caused by compression of the median nerve in the wrist. The ‘tunnel’ is a narrow passageway inside the wrist made up of bones and tissue which connects the forearm to the middle of the palm of the hand. The main symptom people experience is of numbness, tingling and aching of the thumb, index, middle and ring fingers of the hand.
Simple treatments for CTS include wearing a splint either while resting (if your symptoms get worse during the night) or while working (if your symptoms get worse as a result of movement and work). There are also exercises which a physiotherapist or occupational therapist may be able to recommend. Conventional treatment includes the possibility of steroid injections into the affected area which can help with reducing swelling and may help some people, although the symptoms may return after a period. Some people resort to surgery to help release the compressed median nerve. Results from a 2008 Cochrane review of different treatments for CTS concluded that “the results suggest that surgical treatment is probably better than splinting but it is unclear whether it is better than steroid injection. Further research is needed for those with mild symptoms.” (Verdugo et al. 2008)
What about alternative approaches? A 2010 systematic review of treating CTS with acupuncture showed that the evidence for acupuncture as a symptomatic therapy “is encouraging but not convincing” (Sim et al. 2011). So, more research is needed, but it seems that acupuncture does have an effect and a brain imaging study published in 2006 may offer some insight into how acupuncture works:
“In the specific case of acupuncture treatment at the site of injury, the evoked needle sensation may function as a sensory conditioning stimulus. In other words, acupuncture needle stimulation, either by hand or by electricity, generates evoked sensations (and perhaps fascicular involvement)distinct from the pain and paresthesias typically perceived by the brain from that injured region and works to erode the pain memory coded by the chronic pain condition.” (Vitaly Napadow et al. 2007)
A similar study by Napadow showed that acupuncture treatment for CTS patients produces changes in the brain by affecting the hypothalamus and amygdala through the limbic network (responsible for emotional life and the creation of memories) (V. Napadow et al. 2007).
So acupuncture may work by actually changing the way our brain maps the experience of pain, helping us to redesign the maps of our pain, and ultimately to forget our pain. Clearly we still need to make important lifestyle changes so that the pain doesn’t come back as a new map.
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Napadow, V. et al., 2007. Hypothalamus and amygdala response to acupuncture stimuli in carpal tunnel syndrome. PAIN, 130(3), pp.254–266.
Napadow, V. et al., 2007. Somatosensory cortical plasticity in carpal tunnel syndrome treated by acupuncture. Human Brain Mapping, 28(3), pp.159–171.
Sim, H. et al., 2011. Acupuncture for Carpal Tunnel Syndrome: A Systematic Review of Randomized Controlled Trials. The Journal of Pain, 12(3), pp.307–314.
Verdugo, R.J. et al., 2008. Surgical versus non-surgical treatment for carpal tunnel syndrome. In Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd.