A randomized clinical trial of acupuncture versus oral steroids for carpal tunnel syndrome: a long-term follow-up.
We prospectively followed up patients with carpal tunnel syndrome (CTS) in our previous study for 1 year. A total of 77 consecutive patients with electrophysiologically confirmed mild-to-moderate idiopathic CTS were randomized and assigned into 2 treatment arms: 1) 2 weeks of prednisolone 20 mg daily followed by 2 weeks of prednisolone 10 mg daily (n = 39); and 2) acupuncture administered in 8 sessions over 4 weeks (n = 38). In the current study, the patients were further followed up at 7 and 13 months using Global symptom score (GSS) assessments and nerve conduction studies repeated again at 13 months. When comparing with baseline levels, the percentages of patients with treatment failure, moderate improvement, and good improvement were significantly different between the 2 groups at month 7 [10.5, 2.6, and 86.8% for the acupuncture group and 33.3, 7.7, and 59% for the steroid group, respectively (P = .014)] and month 13 [15.8, 2.6, and 81.6% versus 51.3, 0, and 48.7%, respectively (P = .002)]. The acupuncture group had a significantly better improvement in GSS, distal motor latencies and distal sensory latencies when compared to the steroid group throughout the 1-year follow-up period (P < .01). Furthermore, significant correlation was observed between changes of GSS (month 13-baseline) and all parameters of the electrophysiological assessments except for compound muscle action potential amplitude.


CONCLUSIONS
This article demonstrates that short-term acupuncture treatment may result in long-term improvement in mild-to-moderate idiopathic CTS. Acupuncture treatment can be considered as an alternative therapy to other conservative treatments for those who do not opt for early surgical decompression.
Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan.
Chun-Pai
CP
Yang
Nai-Hwei
NH
Wang
Tsai-Chung
TC
Li
Ching-Liang
CL
Hsieh
Hen-Hong
HH
Chang
Kai-Lin
KL
Hwang
Wang-Sheng
WS
Ko
Ming-Hong
MH
Chang
D015667:Acupuncture Analgesia / Q000379:methods*; D000284:Administration, Oral; D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013256:Steroids / Q000008:administration & dosage* / Q000009:adverse effects; D013995:Time
D013256:Steroids