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Carpal tunnel syndrome clinical outcome after low level laser
acupuncture microamps transcutaneous electrical nerve stimulation, and other
alternative therapies--an open protocol study
- Branco K, Naeser MA
J Altern Complement Med 1999 Feb;5(1):5-26
Acupuncture Healthcare Services, Westport, Massachusetts, USA.
OBJECTIVE: Outcome for carpal tunnel syndrome (CTS) patients (who previously
failed standard medical/surgical treatments) treated primarily with a
painless, noninvasive technique utilizing red-beam, low-level laser
acupuncture and microamps transcutaneous electrical nerve stimulation (TENS)
on the affected hand; secondarily, with other alternative therapies. DESIGN:
Open treatment protocol, patients diagnosed with CTS by their physicians.
SETTING: Treatments performed by licensed acupuncturist in a private
practice office. SUBJECTS: Total of 36 hands (from 22 women, 9 men), ages
24-84 years, median pain duration, 24 months. Fourteen hands failed 1-2
surgical release procedures. INTERVENTION/TREATMENT: Primary treatment:
red-beam, 670 nm, continuous wave, 5 mW, diode laser pointer (1-7 J per
point), and microamps TENS (< 900 microA) on affected hands. Secondary
treatment: infrared low-level laser (904 nm, pulsed, 10 W) and/or needle
acupuncture on deeper acupuncture points; Chinese herbal medicine formulas
and supplements, on case-by-case basis. Three treatments per week, 4-5
weeks. OUTCOME MEASURES: Pre- and posttreatment Melzack pain scores;
profession and employment status recorded. RESULTS: Posttreatment, pain
significantly reduced (p < .0001), and 33 of 36 hands (91.6%) no pain, or
pain reduced by more than 50%. The 14 hands that failed surgical release,
successfully treated. Patients remained employed, if not retired. Follow-up
after 1-2 years with cases less than age 60, only 2 of 23 hands (8.3%) pain
returned, but successfully re-treated within a few weeks. CONCLUSIONS:
Possible mechanisms for effectiveness include increased adenosine
triphosphate (ATP) on cellular level, decreased inflammation, temporary
increase in serotonin. There are potential cost-savings with this treatment
(current estimated cost per case, $12,000; this treatment, $1,000). Safe
when applied by licensed acupuncturist trained in laser acupuncture;
supplemental home treatments may be performed by patient under supervision
of acupuncturist.
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