Effect of Manual Acupuncture for Mild-to-Moderate Carpal Tunnel Syndrome: A Systematic Review

OBJECTIVES: Despite the low cost and high accessibility of manual acupuncture (MA) treatments for the carpal tunnel syndrome (CTS), this intervention has not been uniformly evaluated in systematic reviews (SR), and no SR has evaluated MA monotherapy for CTS. This review was conducted to summarize the findings and undertake a quality assessment of randomized controlled trials (RCTs) of acupuncture treatment methods for mild-to-moderate CTS to identify clinical evidence for the use of MA in CTS. METHODS: We searched five databases for articles on relevant RCTs that were published until June 2021 without imposing specific restrictions, such as age or sex, on CTS patients. RCTs that evaluated MA were included without any restriction on comparator interventions. Measurement tools for evaluating pain reduction and functional improvement or for evaluating efficacy using electrophysiological indicators were included as outcome measures. RESULTS: We included seven RCTs, of which three studies reported both post-treatment improvement effects and statistical significance using p-values for all outcomes. Five studies reported statistically significant intergroup differences (p-values for all outcomes) in post-treatment improvement. None of the studies reported severe adverse effects of MA. In all of the RCTs, the reporting rates of the 2c, 2a, and 6a items of STRICTA 2010 were 14%, 29%, and 29%, respectively. PC7 (Daereung) was used to treat CTS in all of the included studies. CONCLUSION: MA can be used for CTS treatment without serious adverse effects. PC7 was the most commonly used acupoint. In order to ensure objective and reliable reporting, accurate standardization of acupuncture treatment methods acupoint terms should be undertaken in future RCTs.