Assessment of the Effectiveness of Ultrasound-guided Acupuncture in the Management of Carpal Tunnel Syndrome
Status:
Unknown status
Trial end date:
2017-09-01
Target enrollment:
Participant gender:
Summary
In clinical practice, carpal tunnel syndrome (CTS) is the common disease of peripheral
neuropathy and usually happened to female, mid-age population, overweight persons, and those
who overused their hands for work or production. Some research claimed this might be
correlated to anatomical characteristics such as the longer anteroposterior diameter or
smaller cross section area of the wrist. Preliminary symptoms often start with sensory domain
(pain, tingling, paresthesia and especially night awakening due to symptoms mentioned above)
and then progress to motor domain (thenar muscle atrophy and clumsiness) if left untreated.
Depending on the severity, patient's willingness and convenience, there are many options for
CTS. For those whose symptoms are mild to moderate, conservative therapies are usually the
first choice, including physiotherapies, local injection and night splints. Local steroid is
proven to be effective to relieve the symptoms of CTS shortly up to 3 months. However, the
effects will decline gradually and repetitive injections is suggestive. The patients with
severe symptoms which comprise thenar muscle atrophy will be advised to receive decompression
surgery.the surgery can alleviate the illness with high success rate up to 70%.
Unfortunately, there are still patients who will relapse or undergo side effects, for
example, finger weakness.
In recent years, acupuncture researches focused on CTS intervention have been outgrowing and
promising. Whereas, there are still lack of evidence which stands for the therapeutic effects
comparing with local steroid injection. This limits the built-up of suspect mechanism of
acupuncture intervention for CTS.
This is a preliminary, randomized and single-blinded study which started since 2016 and last
for a year. The investigators utilize ultrasound to guide the depth of needle penetration
which prevents unnecessarily tissues injury such as artery or dry needle injury. This
procedure also guarantees the needles lie directly on the upper surface of the median nerve.
One group will receive electrical stimulation and another won't. The investigators use
electromyography, cross-section area of median nerve, visual analog scale, Boston Carpal
Tunnel Syndrome Questionnaire, six-item scale, The disabilities of the arm, shoulder and hand
score and Jamar grip dynamometer as outcome measurements. The results gathered from two
experimental groups will be compared with the data from the control group whose participants
only receiving local steroid injection once in the first week. The participants are all above
18 years old and complain of illness for a least 3 months without any surgery or local
injection for a least 1 year. The investigators set up strict exclusive criteria and sample
size estimation is 70.