Journal of Pharmacopuncture (대한약침학회지)

KOREAN PHARMACOPUNCTURE INSTITUTE (대한약침학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Manual Acupuncture for Mild-to-Moderate Carpal Tunnel Syndrome: A Systematic Review

  • Huh, Jeong Ho (College of Korean Medicine, Woosuk University) ;
  • Jeong, Hye In (Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Kyeong Han (Woosuk Institute of Smart Convergence Life Care (WSCLC), Woosuk University)
  • Received : 2021.08.30
  • Accepted : 2021.11.19
  • Published : 2021.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: Despite the low cost and high accessibility of manual acupuncture (MA) treatments for the carpal tunnel syndrome (CTS), this intervention has not been uniformly evaluated in systematic reviews (SR), and no SR has evaluated MA monotherapy for CTS. This review was conducted to summarize the findings and undertake a quality assessment of randomized controlled trials (RCTs) of acupuncture treatment methods for mild-to-moderate CTS to identify clinical evidence for the use of MA in CTS. Methods: We searched five databases for articles on relevant RCTs that were published until June 2021 without imposing specific restrictions, such as age or sex, on CTS patients. RCTs that evaluated MA were included without any restriction on comparator interventions. Measurement tools for evaluating pain reduction and functional improvement or for evaluating efficacy using electrophysiological indicators were included as outcome measures. Results: We included seven RCTs, of which three studies reported both post-treatment improvement effects and statistical significance using p-values for all outcomes. Five studies reported statistically significant intergroup differences (p-values for all outcomes) in posttreatment improvement. None of the studies reported severe adverse effects of MA. In all of the RCTs, the reporting rates of the 2c, 2a, and 6a items of STRICTA 2010 were 14%, 29%, and 29%, respectively. PC7 (Daereung) was used to treat CTS in all of the included studies. Conclusion: MA can be used for CTS treatment without serious adverse effects. PC7 was the most commonly used acupoint. In order to ensure objective and reliable reporting, accurate standardization of acupuncture treatment methods acupoint terms should be undertaken in future RCTs.

Keywords

Acknowledgement

This study was edited to ensure language and grammar accuracy by Editage, a division of Cactus Communications.

References

  1. Urits I, Gress K, Charipova K, Orhurhu V, Kaye AD, Viswanath O. Recent advances in the understanding and management of carpal tunnel syndrome: a comprehensive review. Curr Pain Headache Rep. 2019;23(10):70. https://doi.org/10.1007/s11916-019-0811-z
  2. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999;282(2):153-8. https://doi.org/10.1001/jama.282.2.153
  3. Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273-84. https://doi.org/10.1016/S1474-4422(16)30231-9
  4. Dabbagh A, MacDermid JC, Yong J, Macedo LG, Packham TL. Diagnosing carpal tunnel syndrome: diagnostic test accuracy of scales, questionnaires, and hand symptom diagrams-a systematic review. J Orthop Sports Phys Ther. 2020;50(11):622-31. https://doi.org/10.2519/jospt.2020.9599
  5. Klauser AS, Halpern EJ, De Zordo T, Feuchtner GM, Arora R, Gruber J, et al. Carpal tunnel syndrome assessment with US: value of additional cross-sectional area measurements of the median nerve in patients versus healthy volunteers. Radiology. 2009;250(1):171-7. https://doi.org/10.1148/radiol.2501080397
  6. Shi Q, MacDermid JC. Is surgical intervention more effective than non-surgical treatment for carpal tunnel syndrome? A systematic review. J Orthop Surg Res. 2011;6:17. https://doi.org/10.1186/1749-799X-6-17
  7. Jimenez Del Barrio S, Bueno Gracia E, Hidalgo Garcia C, Estebanez de Miguel E, Tricas Moreno JM, Rodriguez Marco S, et al. Conservative treatment in patients with mild to moderate carpal tunnel syndrome: a systematic review. Neurologia (Engl Ed). 2018;33(9):590-601.
  8. Pourmokhtari M, Mazrooyi M, Vosoughi AR. Conservative or surgical treatment of carpal tunnel syndrome based on the severity and patient risk factors. Musculoskelet Surg. 2021;105(3):315-9. https://doi.org/10.1007/s12306-020-00663-x
  9. Lee JH. Korean medicine for carpal tunnel syndrome: a systematic review of literature published in Korea. J Physiol Pathol Korean Med. 2015;29(1):79-84. https://doi.org/10.15188/kjopp.2015.02.29.1.79
  10. Kim ID, Oh HH, Byun JY, Moon HC, Koh KH, Park SY, et al. Clinical study on the patients with carpal tunnel syndrome. J Korean Acupunct Moxib Soc. 2002;19(6):61-6.
  11. Hyun JY, Shin J, Im CJ, Park J. A systematic review on the reporting quality of acupuncture treatment for carpal tunnel syndrome. Korean J Acupunct. 2020;37(3):131-44. https://doi.org/10.14406/acu.2020.022
  12. Jeon HA, Shin WB, Lim SY, Moon YJ, Lee JY, Ku SH, et al. A narrative review of carpal tunnel syndrome in traditional Chinese medicine: using China National Knowledge Infrastructure database. J Korean Med Rehabil. 2020;30(4):119-32. https://doi.org/10.18325/jkmr.2020.30.4.119
  13. Lim NR, Kim SC, Jang EH, Na WM, Lim SI, Shin JB, et al. Case study of oriental medicine treatment with acupotomy therapy of the carpal tunnel syndrome. J Korean Acupunct Moxib Soc. 2008;25(4):163-70.
  14. Kim JH, Song HS. Traditional Korean medicine therapy for treating carpal tunnel syndrome in patients with wrist pain: a systematic review. Acupuncture. 2015;32(2):59-64.
  15. Sim H, Shin BC, Lee MS, Jung A, Lee H, Ernst E. Acupuncture for carpal tunnel syndrome: a systematic review of randomized controlled trials. J Pain. 2011;12(3):307-14. https://doi.org/10.1016/j.jpain.2010.08.006
  16. Choi GH, Wieland LS, Lee H, Sim H, Lee MS, Shin BC. Acupuncture and related interventions for the treatment of symptoms associated with carpal tunnel syndrome. Cochrane Database Syst Rev. 2018;12(12):CD011215.
  17. Wu IX, Lam VC, Ho RS, Cheung WK, Sit RW, Chou LW, et al. Acupuncture and related interventions for carpal tunnel syndrome: systematic review. Clin Rehabil. 2020;34(1):34-44. https://doi.org/10.1177/0269215519877511
  18. Ministry of Health and Welfare. Korean Medicine Utilization and Herbal Medicine Consumption Survey (KOSIS No. 117087) [Internet]. Sejong: Ministry of Health and Welfare; 2018 [cited 2021 Jun 10]. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=344055.
  19. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
  20. MacPherson H, Altman DG, Hammerschlag R, Li Y, Wu T, White A, et al. Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. Acupunct Med. 2010;28(2):83-93. https://doi.org/10.1136/aim.2009.001370
  21. Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2012;10(1):28-55. https://doi.org/10.1016/j.ijsu.2011.10.001
  22. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions. 2nd ed. Chichester: Wiley; 2019.
  23. Seo HJ, Kim SY, Lee YJ, Jang BH, Park JE, Sheen SS, et al. A newly developed tool for classifying study designs in systematic reviews of interventions and exposures showed substantial reliability and validity. J Clin Epidemiol. 2016;70:200-5. https://doi.org/10.1016/j.jclinepi.2015.09.013
  24. Bahrami-Taghanaki H, Azizi H, Hasanabadi H, Jokar MH, Iranmanesh A, Khorsand-Vakilzadeh A, et al. Acupuncture for carpal tunnel syndrome: a randomized controlled trial studying changes in clinical symptoms and electrodiagnostic tests. Altern Ther Health Med. 2020;26:10-6.
  25. Tezel N, Umay E, Yilmaz V, Cakci A. Acupuncture plus night splint for quality of life and disability in patients with carpal tunnel syndrome: a randomized controlled trial. Integr Med Res. 2019;8(4):284-8. https://doi.org/10.1016/j.imr.2019.11.003
  26. Ural FG, Ozturk GT. The acupuncture effect on median nerve morphology in patients with carpal tunnel syndrome: an ultrasonographic study. Evid Based Complement Alternat Med. 2017;2017:7420648.
  27. Hadianfard M, Bazrafshan E, Momeninejad H, Jahani N. Efficacies of acupuncture and anti-inflammatory treatment for carpal tunnel syndrome. J Acupunct Meridian Stud. 2015;8(5):229-35. https://doi.org/10.1016/j.jams.2014.11.005
  28. Yao E, Gerritz PK, Henricson E, Abresch T, Kim J, Han J, et al. Randomized controlled trial comparing acupuncture with placebo acupuncture for the treatment of carpal tunnel syndrome. PM R. 2012;4(5):367-73. https://doi.org/10.1016/j.pmrj.2012.01.008
  29. Khosrawi S, Moghtaderi A, Haghighat S. Acupuncture in treatment of carpal tunnel syndrome: a randomized controlled trial study. J Res Med Sci. 2012;17(1):1-7.
  30. Yang CP, Hsieh CL, Wang NH, Li TC, Hwang KL, Yu SC, et al. Acupuncture in patients with carpal tunnel syndrome: a randomized controlled trial. Clin J Pain. 2009;25(4):327-33. https://doi.org/10.1097/AJP.0b013e318190511c
  31. Freedman J. Acupuncture for carpal tunnel syndrome. Acupunct Med. 2002;20(1):39-40. https://doi.org/10.1136/aim.20.1.39
  32. Ashworth NL. Carpal tunnel syndrome. BMJ Clin Evid. 2010;2010:1114.
  33. Jung IY, Kim NH, Jeong KS, Yang H, Park KS. Assessment of severity by high resolution ultrasonography in carpal tunnel syndrome. J Korean Neurol Assoc. 2012;30(3):176-81.
  34. Ozsoy-Unubol T, Bahar-Ozdemir Y, Yagci I. Diagnosis and grading of carpal tunnel syndrome with quantitative ultrasound: is it possible? J Clin Neurosci. 2020;75:25-9. https://doi.org/10.1016/j.jocn.2020.03.044
  35. De Angelis MV, Pierfelice F, Di Giovanni P, Staniscia T, Uncini A. Efficacy of a soft hand brace and a wrist splint for carpal tunnel syndrome: a randomized controlled study. Acta Neurol Scand. 2009;119(1):68-74. https://doi.org/10.1111/j.1600-0404.2008.01072.x
  36. Lee HS, Cha SJ, Park HJ, Seo JC, Park JB, Lee HJ. Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. Korean J Acupunct. 2010;27(3):1-23.