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TCM Strategies for Carpal Tunnel Syndrome (CTS)

What Is Carpal tunnel syndrome?

         Carpal tunnel syndrome (CTS) is a common hand condition that affects about 10% of people at some point in their lives. Over 200,000 carpal tunnel surgical procedures are performed yearly in the U.S. (Franzblau & Werner, 1999).


The carpal tunnel is a narrow passage about 1 inch long in the wrists that contains the median nerve and tendons that control the fingers (Walter, 2022). When the carpal tunnel narrows, the median nerve is compressed, causing CTS symptoms such as permanent numbness, tingling, pain in the affected hand(s), muscle atrophy and weakness in the thumb muscle. 

What are the symptoms of carpal tunnel syndrome?


The symptoms of  Carpal tunnel syndrome (CTS) can vary from person to person, but they typically start gradually and get worse over time. Some common symptoms include:

  • Gradual onset of tingling, numbness, and weakness in the thumb(s), index, middle, and half of the ring finger(s) (Walter, 2022)

  • Sensation and pain travel from the hands up to the wrists and arms

  • Weakness in the hand, especially when gripping objects (MayoClinic, 2022)

  • Difficulty making a fist

  • Difficulty typing or using a mouse

  • Symptoms that are worse at night or when the wrist is bent (MayoClinic, 2022)

How does carpal tunnel syndrome happen?


          The median nerve provides sensation to the thumb, index finger, middle finger, and half of the ring finger. It is also responsible for the movement of the wrist and all of the fingers.  Carpal tunnel syndrome (CTS) occurs when the median nerve becomes compressed in the carpal tunnel, a narrow space between the hand and the wrist. This compression can be caused by several factors, including:

  • Repetitive hand and wrist movements or overuse, such as typing or using a mouse (Tsai et al., 2019)

  • Injuries to the wrist

  • Pregnancy

  • Certain medical conditions, such as diabetes or rheumatoid arthritis

  • Obesity

What are the causes of carpal tunnel syndrome in Oriental Medicine?


          Carpal tunnel syndrome (CTS) is a common condition in Traditional Chinese Medicine (TCM) that is thought to be caused by the stagnation of Blood and Qi in the wrists. This stagnation can be caused by the invasion of Wind, Cold, or Dampness, often superimposed on a deficiency of Spleen Qi (Schulman et al., 2010)

          In TCM, Blood is the fluid that nourishes the tissues and organs, while Qi is the energy that moves Blood and other substances around the body. When Blood and Qi stagnate, it can lead to pain, numbness, and tingling in the hands and fingers. Wind, Cold, and Dampness are external pathogenic factors that can invade the body and cause disease. When these factors invade the wrists, they can obstruct the flow of Blood and Qi, leading to CTS symptoms. Spleen Qi is responsible for transporting and transforming nutrients throughout the body. When Spleen Qi is deficient, it can lead to stagnation of Blood and Qi in the wrists, making it more likely to develop CTS.

What can Oriental Medicine do to treat carpal tunnel syndrome?


          Treatment for carpal tunnel syndrome (CTS) in TCM typically involves acupuncture, herbs, and dietary changes. 

         Acupuncture is an alternative medicine modality that involves inserting thin needles into specific points of the body. Acupuncture can help to improve the flow of Blood and Qi in the wrists. There is some evidence that acupuncture can be an effective treatment for CTS. A study found that acupuncture was more effective than primary care or anti-inflammatory medications for reducing pain and improving function in people with CTS (HealthCMi, 2018). The study also found that acupuncture effectively reduced inflammation and restored motor dexterity. Another study found that acupuncture effectively alleviated pain and numbness and improved function in people with CTS after 12 weeks of treatment (Bian et al., 2021). 

          Acupressure is a form of traditional Chinese medicine that involves applying pressure to specific points on the body. There is some evidence that acupressure can be an effective treatment for carpal tunnel syndrome (CTS). A study found that acupressure effectively reduced the severity of symptoms and improved electrodiagnostic findings and hand function in people with CTS. It was safe and well-tolerated by participants in the study. (Asgari et al., 2020). Another study found that acupressure can be an effective self-treatment for CTS patients as it releases muscle tension, relaxes the mind and body, and promotes blood circulation (Kaiser Permanente, 2023). 

          Traditional Chinese Medicine (TCM) is a holistic system of medicine that has been practiced for centuries. Traditional Chinese herbal remedies nourish Blood and Qi and remove Wind, Cold, and Dampness. A study found that traditional Chinese herbal remedies effectively reduced the weakness of the hands and tingling pain in fingers among those with CTS. Another study found that using traditional Chinese herbs to treat CTS may help reduce pain and repair the nerves and damaged tissue. The study found that the herbal formula Shen Tong Zhu Yu Tang was effective in relieving pain, unblocking painful obstructions and meridians, and dispelling blood stagnation (Me & Qi, 2023).

          Moxibustion is a traditional Chinese medicine (TCM) treatment that involves burning mugwort (moxa) over specific points on the body. There is some evidence that moxibustion can be an effective treatment for carpal tunnel syndrome (CTS). A study found that moxibustion helped dilate blood vessels, promote blood flow, and relax the muscles in the treatment area for CTS (Davis, 2022). Another study found that moxibustion decreased the stimulus intensity of the ulnar nerve. The ulnar nerve is one of the nerves compressed in carpal tunnel syndrome. This finding suggests that moxibustion may help to relieve the symptoms of CTS Chan et al. (2018). 

          Cupping is a traditional Chinese medicine (TCM) treatment that involves placing cups on the skin and creating a vacuum. There is some evidence that cupping can be an effective treatment for carpal tunnel syndrome (CTS). A study found that cupping significantly relieved symptom severity and the distal sensory disturbance of the median nerve in people with CTS (Mohammadi, 2019). Another study found that patients with CTS treated with wet cupping experienced a significant decrease in pain and other symptoms (Michalsen et al., 2009). 


          There are several lifestyle changes that can help to reduce the risk of CTS or relieve the symptoms, including: 

  • Monitoring diet, exercise, and supplements: Certain foods and supplements, such as vitamin B6 and magnesium, may help to reduce the risk of CTS. Exercise can also help improve circulation and reduce inflammation, which can help relieve the symptoms of CTS (Lin, 2007). Dietary changes can also help strengthen Spleen Qi and prevent CTS.

  • Avoiding repetitive movements: Repetitive movements of the wrists and hands can put pressure on the median nerve and worsen CTS. If you have CTS, it is important to avoid or limit activities that involve repetitive hand and wrist movements (Cornell, 2022).

  • Taking breaks: When doing activities involving repetitive hand and wrist movements, it is important to take breaks often. It will help reduce the amount of pressure on the median nerve.

  • Using ergonomic tools: Many ergonomic tools can help reduce stress on the wrists and hands. These include keyboards, mice, and chairs designed to minimize repetitive movements and improve posture.

  • Getting enough sleep: Getting enough sleep can help to reduce inflammation and improve nerve function.

  • Managing stress: Stress can worsen the symptoms of CTS. It is important to find ways to manage stress, such as exercise, relaxation techniques, or talking to a therapist.

          Rapha Acupuncture is a traditional Chinese medicine (TCM) clinic in Newport Beach that specializes in women's and men's health. We can help you design the best treatment plan for carpal tunnel syndrome (CTS) using acupuncture and traditional Chinese herbs customized to your symptoms. Our team of experienced acupuncturists and herbalists is dedicated to providing the best possible care to relieve your symptoms and improve your overall health. We offer consultations so you can learn more about our services and how we can help you.
call us today to make an appointment!

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Bian, Z., Yu, J., Tu, M., Liao, B., Huang, J., Jiang, Y., & Fang, J. (2021). Acupuncture and related therapies for carpal tunnel syndrome: A protocol for systematic review and Bayesian network meta-analysis. Medicine, 100(50), e28294. 

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