Effects of Acupuncture Therapy on Clinical and Electrophysiological Findings in Carpal Tunnel Syndrome Nuray Bilge * and Recep Demir Department of Neurology, Faculty of Medicne, Ataturk University, Erzurum, Turkey * Corresponding author: Nuray Bilge, Department of Neurology, Faculty of Medicine, Ataturk University, Erzurum, Turkey, Tel: 05059285228; Fax: 904422361301; E- mail: nuraybilge25@hotmail.com Received date: October 6, 2018; Accepted date: October 26, 2018; Published date: November 2, 2018 Copyright: © 2018 Bilge N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. Abstract Investigating clinical and electrophysiological activity of manual body acupuncture therapy on patients with mild and moderate CTS diagnosis was aimed. In this study, patients diagnosed with mild-moderate level CTS by the clinic and Electromyography (EMG) in first 2 weeks, 3 sessions were performed followed by 2 sessions for 2 weeks and each session was for 30 minutes, a total of 10 sessions of acupuncture practice were performed. In acupuncture therapy, dry needling was practiced using PC-3, PC-6, and PC-7 points. Patients were evaluated by electrocardiographic parameters, paresthesia (numbness, tingling), Visual Analog Scale (VAS), Boston Scale (Symptom Severity and Functional Capacity), Tinnel and Phalen test before and at the first and third months of treatment. Out of 40 patients meeting the participation criteria, 37 were able to complete the study and were evaluated for the result. After the treatment, on the symptoms of numbness and tingling, statistically, significant improvements in Phalen test positivity were compared to pre-treatment (p<0.05). Compared to pre-Acupuncture therapy, the VAS score and Boston Symptom Severity scale in the 1st and 3rd month after treatment showed significant improvements (p<0.01). Among electrophysiological parameters, median nerve distal motor latency (mMDL) was significantly healed in 3rd month after the treatment in respect to before treatment (p=0.01). As a result, the effect of acupuncture therapy practiced using PC-3, PC-6, PC-7 points in mild-moderate level CTS treatment on clinical findings was more apparent compared to electrophysiological findings. Acupuncture treatment in mild to moderate CTS may be a reliable symptomatic treatment option in patients with pain and paresthesia complaints. Keywords: Carpal tunnel syndrome; Acupuncture; Paresthesia complaints; VAS; Boston scale; Electrophysiological parameters Abbreviation CTS: Carpal Tunnel Syndrome; DM: Diabetes Mellitus; CNS: Central Nervous System; VAS: Visual Analogue Scale; BMI: Body Mass Index; SPSS: Statistical Package for Social Sciences Introduction Most commonly seen entrapment neuropathy “Carpal Tunnel Syndrome (CTS)”, occurs as a result of compression of the median nerve at the wrist within the carpal tunnel. As well as many illnesses being shown to cause CTS (rheumatoid arthritis, diabetes mellitus (DM), amyloidosis, acromegaly, myxedema, obesity, pregnancy etc.), in most of the cases occur as idiopathic [1-3]. Classic symptoms on patients with CTS are paresthesia (numbness, tingling) and pain on the median nerve distribution area at the hand (at the frst three fngers radial half of the fourth fnger), which occurs especially at night or with repetitive coercive hand movement and is relieved by shaking the hand or changing position. Weakness in thenar muscles and atrophy are late-period fndings seen in long-term CTS symptoms [1-5]. Pains can spread to outer anatomic innervation area of the nerve and, proximal and shoulder [6]. CTS diagnosis in clinical application is usually made according to the existence of one or more symptoms and results of diagnostic proactive tests. Electrodiagnostic works are valuable in clinically verifying CTS diagnosis and to determine the existence of other neuropathies [1,5]. Electrophysiological methods objectively lead to CTS diagnosis with accuracy at the rate of percentage 91-98 [7]. CTS is treated with conservative methods or surgically. Among conservative methods, there is splint usage, non-steroid anti-infammatory medicine usage, corticosteroid injection in carpal tunnel and physiotherapy modalities [4]. Also, acupuncture and yoga are shown to reduce symptoms in CTS [8]. Acupuncture is an ancient Chinese treatment method done by pricking needles in specifc points [9]. In acupuncture, the application is done to the skin and subcutaneous muscle tissue. About 70%-80% of the acupuncture points are similar with trigger points [10]. Receptors like nociceptor, Meissner’s corpuscles, Krause bulbous, Golgi tendon organ are densely located in acupuncture points [11]. When the needle is applicated in acupuncture points causes a zonal sensation of tension, pressure, warm-up, and pain called “De-Qi” in Chinese literature [12]. Tis may be a sign that proper points were chosen [13]. With pricking in acupuncture points, pain stimulus is transferred to the Central Nervous System (CNS) via nociceptors. Nociceptors are nude and free nerve endings in all skin and subcutaneous tissues sensitive to painful stimuli [14]. Acupuncture has various curative efects through diferent mechanisms, these are; the analgesic efect, homeostatic efect, immunity increasing efect, sedative efect, psychological efect, and motor curative efect. Two theories have been suggested regarding the application of this treatment in pain control. First is that acupuncture can stimulate broad sensory aferent fbers and suppress the sense of pain as understood in gate control theory. Secondly, its provision a pain control efect through inducing opiate-like endogenous substance Journal of Anesthesiology and Pain Research Bilge et al., J anesthesiol pain res 2018, 2:1 Research Article Open Access J anesthesiol pain res, an open access journal Volume 2 • Issue 1 • 1000112 J o u r n a l o f An e st h es i o l o g y a n d P a i n R e s e a r c h