title: Acupuncture for carpal tunnel syndrome: a systematic review of randomized controlled trials.
abstract: Acupuncture is a widely used symptomatic treatment for carpal tunnel syndrome (CTS). The objective of this systematic review was to evaluate the evidence of the effectiveness of acupuncture and acupuncture-like treatments for CTS. Systematic searches were conducted on 11 electronic databases without language restrictions. All randomized controlled trials (RCTs) of acupuncture as a treatment of CTS were included. Methodological quality was assessed using the Cochrane risk of bias tool. Six RCTs met our inclusion criteria. Their methodological quality was generally low. Two RCTs compared the effectiveness of acupuncture with a sham control. The others used active controls. A meta-analysis of acupuncture versus steroid block therapy favored acupuncture (2 studies, n = 144; risk ratio, 1.28; 95% CI, 1.08 to 1.52; P = .005; heterogeneity, I(2) = 10%) in terms of responder rate. Our systematic review and meta-analysis demonstrate that the evidence for acupuncture as a symptomatic therapy of CTS is encouraging but not convincing. The total number of included RCTs and their methodological quality were low. Further rigorous studies are required to establish whether acupuncture has therapeutic value for this indication.
  
  
  CONCLUSIONS
  This systematic review of RCTs focused on clinical trials testing the effectiveness of acupuncture for CTS. The existing evidence is not convincing enough to suggest that acupuncture is an effective therapy for CTS. Further RCTs should overcome the limitation of previous studies.
authors.affiliation: School of Korean Medicine, Pusan National University, Yangsan, South Korea.
authors.forename: Hoseob
authors.initials: H
authors.lastname: Sim
authors.forename: Byung-Cheul
authors.initials: BC
authors.lastname: Shin
authors.forename: Myeong Soo
authors.initials: MS
authors.lastname: Lee
authors.forename: Aram
authors.initials: A
authors.lastname: Jung
authors.forename: Hyangsook
authors.initials: H
authors.lastname: Lee
authors.forename: Edzard
authors.initials: E
authors.lastname: Ernst
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D002349:Carpal Tunnel Syndrome / Q000628:therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic