February 2011 : Acupuncture and Carpal Tunnel Pain

Carpal tunnel syndrome, or CTS, is a very common health complaint in our society. While it is generally believed to be associated with the overuse of the wrist joint in any repetitive motion, especially while typing or using a computer, it can also be caused by rheumatoid arthritis, diabetes, hypothyroidism, or edema. So if it has all these contributing factors, what exactly is CTS?

The carpal tunnel itself is an anatomical area of the wrist. Look at your wrist with the palm facing up. When you flex your fingers towards the floor you can see the tendons in your wrist become tight. These tendons, and more you can’t see, attach to your fingers and the other small bones in your hand, so that you have the ability to flex and extend them, moving them up and down.

The area called the carpal tunnel is made up of the small bones of the hand, arranged along the bottom and sides of the “tunnel” and then a major ligament, the transverse carpal ligament, forms the top. Within this tunnel run the tendons for your fingers, plus arteries and veins. The most important part that runs within it is the median nerve. This nerve provides most of the sensation in your hand as well as conducts the nerve signals from your brain that tell it how and when to move. So now back to the idea of overuse. Any tendon can become inflamed when overused, like tennis elbow for example. Inflammation includes swelling. Swelling in the carpal tunnel, which isn’t a large space, quickly presses on the median nerve, causing excruciating pain. You don’t want to use that hand because it hurts but not many of us can get thru a day without having to use our hands!

Treatment options, from a traditional Western medical point of view, include a wrist splint to help immobilize the wrist and give it a chance to rest, shots of vitamin B or cortisone, and pain killers. Ergonomic solutions, especially for using a keyboard, are also recommended and then, as a last resort, surgery may be the only way to relieve the pressure in the carpal tunnel. In the case of disease, the primary condition would have to be relieved first, in the hopes that it would help the carpal tunnel.

Acupuncture can definitely be used to relieve pain from CTS. Several studies have shown this is an effective way to manage and even eliminate this problem. From a Chinese medical point of view CTS is simply Qi (energy) and Blood stagnation in the joint. If you are having CTS secondary to RA or diabetes or hypothyroidism, then we can work on both the immediate pain in your wrist as well as the underlying health problem that causes it. The advantage to using acupuncture for CTS is that you will generally have relief faster than with conventional approaches while also not subjecting yourself to the side effects of any medications. Significant improvement can generally be expected within 4 treatments.

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