Acupuncture for Carpal Tunnel Syndrome

How Chinese medicine understands carpal tunnel syndrome

Carpal tunnel syndrome is a biomedical diagnosis. Chinese medicine looks at the symptoms themselves: numbness, tingling and aching in the hand. These are usually understood as a form of Bi syndrome, where Qi and Blood cannot flow freely through the channels of the wrist and hand. Numbness in particular is often read as the tissues not being nourished.

The common patterns are:

• Qi and Blood stagnation. Pain and tingling after repetitive work, worse with use, with tightness in the forearm. This is the pattern most linked to strain.
• Blood deficiency. Numbness more than pain, often with tiredness, pale skin or dizziness. Treatment aims to nourish as well as to move.
• Damp. The hands feel swollen, stiff and heavy, often worse in the morning or in damp weather. This is common when carpal tunnel appears during pregnancy.
• Cold. The aching is worse in the cold and better with warmth.

The pattern shapes which points are chosen and whether treatment focuses on moving circulation, warming, clearing fluid, or building up what is lacking.

What treatment involves

Your first visit at the clinic in Keswick covers when the symptoms started, which fingers are affected, what you do with your hands at work and at home, and your general health. Bring any nerve test results your doctor has.

Acupuncture is usually the main treatment. Points are commonly chosen around the wrist and hand, and along the forearm and upper arm where the channels run. Needles are very fine, between 0.14 and 0.30 mm. Electroacupuncture, a mild current between two needles, is one of the methods studied for carpal tunnel.

I treat the whole body in every treatment, not only the wrist. If your neck or shoulders are tight, that needs to be addressed too. The median nerve runs from the neck, through the shoulder and down the arm to the hand, and the channels used in Chinese medicine follow the same path, so tightness higher up is treated as part of the same problem.

For a Cold pattern, moxibustion can add warmth. Tuina massage can release tight forearm muscles. When a deficiency or Damp pattern is part of the picture, Chinese herbal medicine is a formula written for your pattern.

Treatment here is meant to be part of a plan with your doctor, not a replacement for it. Research on acupuncture for carpal tunnel is still developing. Plan on 5–10 treatments to judge progress.

Between visits

• Wear a night splint if your doctor recommends one. It keeps the wrist straight while you sleep, when symptoms are often worst.
• Keep your wrist neutral. Set your keyboard and mouse so your wrists are level, not bent up or down.
• Take breaks. Rest your hands for a few minutes every half hour during repetitive work.
• Ease your grip. Use a lighter grip on tools, pens and your phone, and avoid vibrating tools where you can.

When to see your doctor first

See your doctor before starting treatment, or promptly if you are already coming in, if:

• Numbness is constant rather than coming and going.
• The muscle at the base of your thumb looks thinner, or your grip is getting weaker.
• Symptoms started after a wrist injury or fall.
• You have symptoms in both hands along with numbness elsewhere, balance problems, or neck pain. The cause may not be at the wrist.
• You have diabetes, thyroid disease or are pregnant and the symptoms are new.

Severe or worsening carpal tunnel can damage the nerve, and some people need a steroid injection or surgery. Your doctor can arrange nerve testing to see how much pressure there is.