Carpal Tunnel and Acupuncture
Many people suffer from carpal tunnel, any type of career or job, daily activity can contribute to carpal tunnel. For
these individuals, wrist pain is a constant pain and always in the forefront of their mind.

It has been studied that most people whose jobs cause or worsen wrist pain are not dealing with true carpal tunnel
syndrome. In fact they are dealing with inflammation in trigger points caused by repetitive strain on the arm and hand
muscles. These trigger points mimic the symptoms of carpal tunnel and can be completely eliminated with acupuncture.

True carpal tunnel means that the median nerve, which runs from the forearm and down the center from the wrist to the
hand, is compressed. This compression causes pain, numbness and tingling, and sometimes weakness in the wrist, arm and
hand. Structural malformations that compress the median nerve are not necessarily unusual, for example, a wrist
fracture or inflammation from arthritis can compress the area but they are not as common as carpal-tunnel.

So why is an improper diagnosis of carpal tunnel syndrome so problematic? Initial medical treatment for carpal tunnel
includes wrist splinting, NSAID drugs and cortisone shots. Not great, but no more harmful than conventional pain
management for any other condition. But with carpal tunnel, when these measures don’t work, people turn to surgery
relatively quickly because their condition often threatens their livelihood. Acupuncture could help many patients from
unnecessarily going under the knife.

If the pain is mainly on the back of the wrist, there may be trigger points in one or several of the wrist extensor
muscles, extensor carpi ulnaris, extensor carpi radialis brevis and extensor carpi radialis longus. Pain from extensor
ulnaris trigger points tends to concentrate on the pinky side of the wrist while radialis brevis trigger points refer
pain to the center of the wrist and slightly down the hand. Radialis longus trigger points, in addition to wrist pain,
refer pain to the outside of the elbow.

For inside-of-the-wrist pain, an acupuncturist may suspect trigger points in the hand flexor muscles, the flexor carpi
radials and flexor carpi ulnaris. The pronator teres, whose trigger points refer pain to the thumb side of the inner
wrist up into the forearm, also can be involved.

Another forearm muscle, the palmaris longus, can harbor trigger points that cause pain and tingling in the inner wrist
and up into the forearm. Accompanying hand pain can help differentiate this muscle. The palm is the primary referral
area for trigger points in the palmaris longus, so in addition to wrist pain, there also would be pain in the center of
the palm.

Trigger points directly in the hand, in a muscle called opponens pollicis, can cause lower wrist pain on the thumb side
of the inside crease. Trigger points in this muscle are common in people whose hands and especially thumbs are very
active. For example, the opponens pollicis is one of the first places acupuncturists look when people complain of
BlackBerry thumb.

While most wrist pain comes from trigger points in the arm and hand muscles, the scalene muscles of the neck also can
play a role. Trigger points in the scalene can cause back-of-the-wrist pain that extends into the fingers, as well as
thumb-side pain on the inside of the wrist. This type of wrist pain is distinguishable by the accompanying upper arm,
back or chest pain.

Trigger points in another upper-body muscle, the pectoralis minor, can cause referred pain to the wrist. Most pain from
pectoralis-minor trigger points is at the front of the shoulder, but there is a common spillover pattern that extends
down the inside of the arm and wrist, all the way into the ring and pinky fingers.

Considering the risk-benefit ratios of various wrist-pain treatments, acupuncture should be a first-line option rather
than a last resort.

Acupuncture is safer than NSAIDs and cortisone shots, and it actually eliminates the pain source rather than
temporarily masking symptoms. Compared with surgery, acupuncture is cheaper and less invasive, and has a higher
probability of providing relief in people who don’t have a structural malformation. In relatively rare cases of true
carpal tunnel syndrome, acupuncture can help manage post-operative trigger points that form in scar tissue and
surrounding fascia.

Wrist pain burdens our system not only in the form of medical expenses but also lost wages. Before labeling it all
carpal tunnel, let’s look to acupuncture for a new perspective on this prevalent problem.

If you think you suffer from carpal tunnel, call AAHOM Acupuncture to schedule a complimentary consultation. See how
acupuncture can help your health concerns.

John McGimsey and Li Jie McGimsey
1168 S. Kings Drive
Charlotte, NC 28207
Charlotte Office:704-737-4412
Davidson Office:704-737-4412
Morganton Office:828-413-0567