Randomized controlled trial comparing acupuncture with placebo acupuncture for the treatment of carpal tunnel syndrome

Yao, E.

Gerritz, P. K.

Henricson, E.

Abresch, T.

Kim, J.

Han, J.

Wang, K.

Zhao, H.

PM & R : the journal of injury, function, and rehabilitation

2012

4(5)

367-373

RCT

RCT

Nervous System Diseases

Carpal Tunnel Syndrome

Acu Versus Sham

Acupuncture

TCM Acupuncture Style

Fixed Acupuncture Protocol

Restricted Modalities, Acupuncture Only

Sham Control

Penetrating Sham

Standard Needling Depth

Verum Acupoint Control

OBJECTIVE: To investigate the efficacy of acupuncture for the treatment of mild to moderate carpal tunnel syndrome (CTS). DESIGN: Prospective, randomized, placebo-controlled, double-blinded study. SETTING: Single-center study. PARTICIPANTS: Forty-one acupuncture-naive adult subjects with mild to moderate CTS enrolled in the study. Thirty-four subjects completed the study. METHODS: Clinical diagnosis of CTS was supported by electrodiagnostic findings. Subjects were randomly assigned to either (1) acupuncture (n = 21) or (2) placebo acupuncture (n = 20) with use of Streitberger placebo acupuncture needles. Both groups received weekly sessions of acupuncture for 6 weeks. Wrist braces were provided to both groups to wear at night, and compliance was monitored. MAIN OUTCOME MEASUREMENTS: The primary outcome measurement was subject-reported change in the Carpal Tunnel Self Assessment Questionnaire (CTSAQ) Symptom and Function scales immediately after and at 2 weeks and 3 months after the final treatment. The secondary outcomes included tip and key pinch strength and combined sensory index. RESULTS: Compared with pretreatment baseline values, subjects in the acupuncture group had 0.58 improvement (P = .03) on the CTSAQ Symptom scale score at 3 months after the last treatment, whereas 0.81 improvement (P = .001) was noted in the placebo acupuncture group. No statistically significant difference was found between the groups treated with acupuncture and placebo acupuncture with respect to improvement in CTS symptoms, function, tip/key pinch, or combined sensory index. CONCLUSIONS: To our knowledge, this study is the first randomized, placebo-controlled, double-blinded prospective study of traditional acupuncture for CTS. Both the treatment and placebo groups demonstrated improvements from baseline. Acupuncture was not shown to be superior to placebo acupuncture when used in conjunction with bracing for patients with mild to moderate CTS.

Nervous System Diseases

1/WK

41

6 Weeks