Carpal Tunnel Syndrome
This content is produced by Houston Acupuncture and is for informational and educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Intro to Acupuncture for Carpal Tunnel Syndrome
Welcome, everybody. I’m Dr. David Cherian. I’m a board-certified physician and a licensed acupuncturist practicing in Houston, Texas. I created Houston Acupuncture and Primary Care to fill a gap I saw in our healthcare system and philosophy.
That gap is this: in Western medicine, we often measure things with numbers, lab tests, and X-rays—but what we’re feeling doesn’t always correlate with those numbers. The labs and imaging studies might not explain our symptoms, or it just doesn’t match how we feel. And I realized, there’s a lot we don’t fully understand in Western medicine.
So I’ve been on a quest to find out: are there other systems, other frameworks, that can help us understand how the body works and what causes health and disease? That quest led me to Eastern medicine—and that’s what we talk about on this show.
We explore the nexus between Eastern and Western medicine: what causes disease in both frameworks, and how we can use both systems to optimize our health and get the best possible outcomes.
Western Medicine
So today we’re going to talk about carpal tunnel syndrome. It’s a common condition we see in the clinic. I’ll briefly review the Western aspect of carpal tunnel syndrome, and then we’ll spend the bulk of our time talking about the Eastern perspective.
You can find most of the information about Western treatments for carpal tunnel syndrome on hundreds of websites and videos out there so I don’t want to spend too much time on that, what I want to give the majority of our attention today is to the Eastern aspect. But briefly—carpal tunnel refers to symptoms of numbness, tingling, pain, and weakness in the hand and wrist, caused by entrapment of the median nerve.
You’ve got one of the major nerves of the hand—the median nerve—and it runs right down the center of the wrist. It passes through a narrow tunnel surrounded by the transverse carpal ligament and the carpal bones. What happens is that pressure inside this tunnel starts to compress the nerve, and that’s what causes all the symptoms: pain, tingling, weakness in the hand. Patients can lose hand grip strength. You also get areas of numbness, especially on the thumb, the pointer, and the middle finger. That pattern is pretty specific for carpal tunnel.
So you can see the anatomy—and this is why wearing a splint is one of the recommended treatments. When you’re wearing a splint, you’re trying to keep the wrist in a neutral position, which takes some of the pressure off the nerve that’s getting squeezed inside the tunnel. That’s also similar to what physical therapy aims to do.
When it comes to medications, doctors usually recommend anti-inflammatories—over-the-counter stuff like Tylenol, aspirin, those kinds of things. Beyond that, treatment options are somewhat limited. Doctors might consider steroid injections, and then you’re looking at surgery. So we get patients all the time who have tried the basic strategies and they really want to avoid surgery if at all possible.
Questions About My Symptoms and Relief
So let’s go through some common questions that patients ask me about carpal tunnel syndrome.
Can acupuncture and herbal medicine help with the pain, tingling, numbness and weakness in my hands?
The answer is yes. That’s our goal in the treatment process. We’re not trying to treat numbers or x-ray images—we’re trying to help you feel better.
For my patients, I try to quantify the severity of their symptoms at the first visit. I usually ask: On a scale of 1 to 10, how bad is the pain? How intense is the tingling? How often are you dropping items because of handgrip weakness?
Then, over the course of treatment—usually over several weeks—I ask at every visit: “How are the symptoms improving? Is your pain level coming down? Is your hand feeling stronger? Are you dropping items less?” And most of our patients do see improvement in these areas.
Will I feel better right away, or does it take a few treatments to work?
It varies. I’d say about half of our patients notice some improvement after the first treatment. And the majority of patients will start to feel better after about four to five treatments. But again, it depends—it depends on how long you’ve had the problem and on the underlying cause from a Chinese medicine perspective.
Usually at the first visit, when I’m done with the evaluation, I try to give an estimate of how long I think your particular case will take. I always recommend for a brand new patient, before coming for the first time to plan for a few months of treatment—typically three to six months. If it gets better sooner, that’s great. But I don’t want you to come in expecting that, because it might not be your case. That being said we do have patients who feel immediate relief, even after just one visit.
Another point I try to emphasize to patients: The health benefits of Chinese medicine—acupuncture and herbs—go beyond just symptom relief. We’re not just trying to get the numbness or tingling or weakness to go away, we’re actually trying to do something more important which is improve your underlying health so that you can have lasting relief.
Often, the symptoms of carpal tunnel are just a manifestation of deeper health issues. If we can treat the root of the problem, we can help the carpal tunnel symptoms—numbness, tingling, weakness—in a more definitive way.
Can Chinese medicine help me avoid surgery or cut down on pain meds?
Yes. That’s one of the main reasons patients come to us. They’re not getting enough relief from splints, therapy, or medication, and they’re looking for something else. We also see patients who’ve been recommended for surgery and want to avoid it. And in many of those cases, we’re able to help them so they no longer need surgery.
One of our goals is to help patients reduce or even completely stop their medications. Some of the common pain meds used for carpal tunnel syndrome include ibuprofen, Aleve, and naproxen. These medications have side effects—they can cause gastric ulcers, kidney damage and other problems—especially with long-term use. Patients don’t want to be dependent on them. So our goal, when you come to our clinic, is to help you get off long-term medications and ideally avoid surgery.
Usually on the first visit, I ask my patients: Are you taking any medications for your carpal tunnel syndrome? And the patient will tell me they take such and such medication at this strength dose this many times. And then during follow-ups, I ask again: How many tablets are you taking per day now? And we’ll compare that to when they started. And what’s interesting is that, most patients, over time, naturally decrease how much pain medication they require—and often times they don’t even realize it until I ask. It’s one of the more objective ways we measure improvement in our patients with Carpal Tunnel Syndrome.
Questions About How It Works
How do you look at carpal tunnel through the lens of Chinese medicine?
So in Chinese medicine, when I think about carpal tunnel syndrome, I think about the channels running through the affected area. In Chinese medicine, all the internal organs have pathways that run through the trunk, the arms, and the legs. And specifically with carpal tunnel syndrome, there are a few organs that run through the wrist and hand; those are the Pericardium, the Lung and Large Intestine, and the San Jiao meridian.
Earlier, I talked about how carpal tunnel symptoms usually affect the central to radial side of the hand—the thumb, the pointer finger, the middle finger, and sometimes the ring finger. In acupuncture theory, those areas are governed by a few key channels:
- The pericardium, which runs along the path of the median nerve, right down the center of the palm
- The lung and large intestine, which run along the radial aspect of the arm
- The San Jiao meridian, which runs along the posterior midline of the arm and hand
So when a patient comes in with carpal tunnel syndrome, I ask them, “What kind of symptoms are you having?” And, “Where exactly are you having the problem?” And that tells me which channels are specifically involved in their case.
A lot of times, other organs are contributing as well. It might be a different organ that’s affected first, and then causing a secondary effect on the pericardium, lung, large intestine, or San Jiao. If that’s the case we have to go back and treat the initial organ that’s causing the problem.
That’s why, when you come to my clinic, I ask a lot questions about your overall health—not just about the carpal tunnel symptoms. I want to get a full picture of your health and see if there are other issues that might be contributing, so we can get to the correct diagnosis.
Are there acupuncture points or herbs that help with nerve healing or inflammation?
For most patients in my clinic, I use a wide variety of points—usually a combination on the arms, legs, and trunk. That’s because we’re treating the whole body and trying to address the underlying problem.
But there are a couple of commonly used points for carpal tunnel syndrome. I’ll give you two examples:
- Pericardium 6: Which is located just above the transverse crease of the wrist, right between the two tendons in the middle of your wrist.
- San Jiao 5: This point is on the San Jiao meridian, on the backside of your forearm, about the same distance above the wrist crease as Pericardium 6—right between the radius and ulna bones.
I usually use both of these points in combination with others. They are also points I recommend for patients to massage at home. During your visit, I can show you exactly how to locate them and how to massage them. Massaging the point is not as potent as inserting an acupuncture needle, but it’s still helpful—and it’s something you can do in-between treatments.
How will I know if the treatment is working?
Compared to Western medicine, Eastern medicine is very different. In Western medicine, we’re often tracking lab values and numbers. But in Eastern medicine, the primary emphasis is: Are you feeling better? So one of the main ways we know if the treatment is working is if your pain and symptoms are improving. If the things we talked about at the first visit—like grip strength, dropping items, or medication use—if those things are getting better, that’s a strong indicator that the treatment is working for you.
And then from my end, I also look at physical exam findings. In Chinese medicine, that includes checking the tongue and the pulse. Based on my analysis, if those things are improving, that’s another sign that the treatment is working.
Questions About My Body Type
Do you treat deeper things like kidneys or digestion, even if the pain is just in the wrist?
Yes. A lot of times, the pain you’re feeling in the wrist—or the weakness, tingling sensation—may not actually be a wrist problem from a Chinese medicine perspective. What do I mean by that? In Western medicine, we think of carpal tunnel syndrome as a wrist issue. You’ve got the median nerve that gets pinched, and that causes all these symptoms. But in Chinese medicine, we look at a patient’s health and their diseases more holistically. A problem you’re feeling in your hands may not be limited to just the wrist—it’s likely connected to the health of your internal organs.
And like we talked about earlier, there are meridians that run directly through the arm and hand, right in the area affected by carpal tunnel syndrome: the pericardium meridian, the San Jiao meridian, the lung and large intestine meridians. These are all in the distribution of carpal tunnel symptoms, but they’re also connected to internal organs. They interact with all of the other organs. The health of one organ influences the others.
So yes, we often have to treat deeper things—like the kidneys, digestion, liver, or lungs—even if the pain is just in the wrist.
I have other health problems in addition to carpal tunnel syndrome. Will acupuncture and herbal treatment help those as well?
Very commonly, patients come in for one particular issue—say, carpal tunnel syndrome—and as we go through their history, they start mentioning other health problems. Things they’ve been formally diagnosed with, and other symptoms that maybe don’t have a formal diagnosis. It could be trouble sleeping, back pain, fatigue—a wide variety of things. And one of the things I explain to patients is: if we get to the root of your problem—what’s the underlying cause of your carpal tunnel syndrome—there’s a good chance that same root issue is also contributing to those other symptoms.
It’s kind of like this: imagine your house has a foundation problem. You might notice your floorboards or tiles start cracking. But it doesn’t stop there. The walls might shift, the sheetrock might break, the roof might start having issues. A whole cascade of problems can happen because of one underlying issue.
And it’s similar in our health. When one organ starts to go off track, it can impact neighboring organs. You start seeing a wide variety of symptoms develop. So our treatment is holistic. We’re trying to get to the root cause—and when we do, we often help with other medical problems as a result.
Questions About What I Can Do
Can you show me a few spots I can press or massage myself?
I’ll show you two common points that I use for carpal tunnel syndrome—I mentioned these briefly earlier. The first one is called Pericardium 6. It’s a little bit above your wrist, right in between the tendons. If you feel along your forearm, you’ll notice two tendons that run parallel to each other. You want to massage right in between those. You can apply pressure, or massage it in a circular motion. That’s one of them.
The other point is at a similar level, just on the back side of the wrist. Again, it’s in the central part of the wrist, right between your radius and ulna bones. This point is called San Jiao 5. It’s along the San Jiao meridian, which travels along the back of the wrist and into the hand.
Those are two common points we use. When we do acupuncture, we’re able to go deeper—penetrate the skin and stimulate the channel more directly—which gives a stronger effect. But even just massaging those two points can sometimes help alleviate symptoms of carpal tunnel syndrome.
Have you treated other patients with carpal tunnel syndrome, and what kind of results have you seen?
Carpal tunnel syndrome is one of the relatively more common conditions we see in clinic. A lot of people have it—especially nowadays, with all the typing and computer work we do. In the vast majority of cases, we’re able to help patients avoid surgery. Most of the time, we can reduce their pain levels and cut down how much pain medication they’re using, and in many cases, get them off of medications completely.
Do you mix Western and Chinese medicine when you treat carpal tunnel syndrome?
So my approach—I usually recommend patients to continue whatever Western medicine treatment they’ve already been prescribed. For carpal tunnel syndrome, that’s usually over-the-counter pain medications. I explain that as the treatment progresses, they should naturally need those medications less. And when they feel their pain improving, they can start cutting back.
When it comes to surgery, most of the time I recommend patients give acupuncture and herbal medicine a trial for a few months before deciding to move forward with surgery. That gives us time to see if we can get them to a better place—hopefully where they don’t need surgery anymore and can avoid an unnecessary procedure. Of course, this is varies from patient to patient and we would need to make that decision in conjunction with their treating surgeon.
Outro
That brings us to the end of our show for today. Thanks for sticking around, and I hope the information we shared was helpful as you consider your treatment options for carpal tunnel syndrome.
If you found today’s show helpful, please like and subscribe. And if you’re interested in learning more about what we do, you can visit us at www.houstonacupuncture.com. You can also email us directly at office@houstonacupuncture.com.