Can acupuncture help relieve wrist pain - possibly carpal tunnel?

A:  We note the question mark after the mention of carpal tunnel - has this been mentioned in passing or is this one of several possible diagnoses offered?
 
Generally speaking, the evidence for the treatment of carpal tunnel syndrome with acupuncture is a little patchy. Our factsheet
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/carpal-tunnel-syndrome.html
 
spells out the fact that the trials which have been held have been equivocal, although it does make the point that the use of 'sham' acupuncture as a control is always a problem. The idea that a needle inserted 'just anywhere' has no effect is wrong, and should be better understood as the contrast between needling at a classically known site against needling elsewhere at a site which may sometimes contingently have more effect than the classical point.
 
The symptoms of carpal tunnel are relatively distinct. The condition is believed to result from the impingement of the median nerve by the tendons of the inner arm as they narrow at the wrist, and symptoms will follow closely the distribution of the nerve itself. While this may cause pain and discomfort in the wrist itself, there are a number of other conditions which can also affect the wrist and which can be very painful. A neurological assessment should rapidly identify what is happening.
 
However, there is something of a risk in discussing named western conditions and their treatment with acupuncture. Although the ancient Chinese probably has some understanding of nerves, their system of medicine was built on an understanding of the flow of energy, called 'qi', in the body and the functional nature of the internal Organs in distributing and maintaining this flow. The manifestations of pain and the precise location often showed the nature and cause of the disturbance in energy flow, and the needles were used to correct the problem, along with any more general or lifestyle advice which the patient needed. The danger of 'mixing systems' is that it becomes more difficult to understand from the conventional medical perspective how the traditional acupuncture perspective can work. 
 
Our clinical experience is that the symptoms associated with carpal tunnel syndrome and other wrist pains can often be relieved with acupuncture treatment, but the critical questions are how much relief one can get and how sustainable it is. Clearly the evidence for the reduction of pain and inflammation by acupuncture treatment is good, but this is of no use to a patient if the relief only lasts for a day and costs a small fortune to maintain.
 
Our best advice is always in cases like yours to see a BAcC member local to you for a face to face assessment of whether acupuncture treatment may help, and also to ensure that you get a thorough neurological asessment too. There are some conditions where surgery or splinting is a serious option, and you need to be able to get yourself on this pathway in case other forms of treatment do not help.   
 
 

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