Carpal Tunnel Syndrome (CTS) is a very common disease in our society which stems from repetitive stress on the hands and wrists. Over time this leads to inflammation and swelling of an area of our wrist called the carpal tunnel.
The structures that run through the carpal tunnel are flexor tendons (flexes fingers and wrists) and the median nerve. The median nerve is what causes the symptoms of CTS. A swollen and inflammed carpal tunnel will press upon the median nerve which will then cause pain, pins and needles, numbness and/or weakness of the wrist, thumb, index and middle finger of the affected hand. Commonly, someone with CTS will complain of waking up in the middle of the night with pain which is subsequently relieved by shaking the hand. CTS can get quite debilitating when it becomes severe – the pain becomes unremitting and constant over the affected area.
My approach to the medical treatment is: 1. Rest and anti-inflammatory medications 2. Exercises for carpal tunnel strengthening 3. Night splints 4. Steroid injection under ultrasound 5. Referral to orthopedic surgeon for consideration of surgery. The best time for the use of laser acupuncture is before ultrasound guided steroid injections. The way I see the laser acupuncture is that it is a non-invasive and safer alternative to the steroid injection. The body is producing it’s own (endogenous) anti-inflammatory steroids and I use the laser acupuncture to basically guide it to the right area.
My favourite acupuncture point for this condition is (unsurprisingly) not actually on the wrist, but is located on the face on a particular tender acupuncture point. Then review and repeat if necessary in 2 weeks time. My success rate seems to be 60 – 70%. Laser acupuncture won’t work on everyone. However, it is always worth a try of a non-invasive and more natural option.
Sometimes the improvements from acupuncture are completely negated by the aggravation that their physical work puts on their wrist. No progress is made – it’s no worse but not better. In that case, one must consider a change of work or work duties.
Case #1:
A daughter bought her elderly 88 year old mother with diagnosed bilateral carpal tunnel pain among many other pains. She has widespread arthritis and is on a strong immunomodulator medication under the supervision of a rheumatologist. This no doubt is controlling her pain but she still is in daily pain and was not keen on using strong pain killers. She did not want surgery I treated her with my favourite face point for about 1 second of red laser. Within 10 seconds she was able to hold a jar with much reduced pain to her wrist. Each wrist only took one treatment. Each treatment being 2 weeks apart. She came back in the 3rd session complaining instead of right thumb arthritis pain which I subsequently treated. She was no longer complaining of her CTS pain!
Pain behaves in layers like an onion. After you remove the top layer of pain, patients often present with another different pain elsewhere that was always present but that the previous pain was distracting from. Often, especially with the elderly, it is not possible to eliminate all pains but we aim to unpeel the pain layers as deeply as possible.
Previously she was unable to do her beloved gardening and now she is at least able to get out there in the dirt for some period of time. Of course, over use of her wrist will flare up her CTS again which will require rest and re-treatment. Overall, she an improved quality of life with a chance to do what she loves.
Case #2:
52 year old lady with ongoing CTS despite physio, night splints, anti-inflammatory medications and ultrasound guided steroid injections. After 4 sessions of laser acupuncture, she had forgotten she had CTS until she looked into her drawer and saw her night splint.
Some people respond stronger and quicker to acupuncture than others. My elderly patient from case #1 only requires one treatment for each wrist. Although she is in the minority, most often people require 2-4 sessions for maximal effect with CTS. And that is assuming that they don’t aggravate it.
