7.1 Acute Musculoskeletal Pain
137
7.1.7 Carpal Tunnel Syndrome (CTS)
Description
■ Mechanic compression of the median nerve in the carpal tunnel
■ Pain in the wrist and hand, may radiate to the upper arm or shoulder
■ Numbness, tingling, and/or paraesthesia of the fingers I–III and the radial side of fin-
ger IV, in chronic cases atrophy of the thenar eminence
■ Acute onset through overuse of the hand
■ Often exacerbation during the night
Point Prescription
French points
■ Local point:
Wrist
(
›
6.2.1)
■ Relaxing point:
Diazepam
(
›
6.7.3)
■ Analgesic point:
PGE
1
/Thymus
(
›
6.7.6)
Chinese points
■ Local point:
Wrist (67)
(
›
6.2.1)
■ Relaxing point:
Muscle Relaxation (98a)
(
›
6.1.3)
■ Analgesic points:
Thalamus (26a)
,
Occiput (29)
(
›
6.7.4),
Apex of Tragus (12)
(
›
6.7.3)
Treatment Intervals
■
Acute stage:
3 times weekly
■ Pain for > 4 weeks: once or twice weekly until symptoms have subsided completely,
provided there is progressive improvement
• During the treatment course the patient should use the affected hand as little as pos-
sible.
• If there is no improvement after 4 weeks of treatment the patient should be referred
to an orthopaedic consultant for endoscopic surgery in order to avoid permanent
nerve damage. In such cases acupuncture can provide peri/postoperative support.
Treatment Course and Prognosis
■ Significant reduction of symptoms within 1–2 weeks
■ Start of treatments during the
acute stage:
symptoms generally resolve within 4 weeks
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