Acupuncture and Ergonomic interventions in the management of carpal tunnel syndrome among industrial workers- Case studies

Ganiyu Oluwaleke Shokunbi



Background:  There are several studies on carpal tunnel syndrome (CTS), but despite this, considerable uncertainties and controversies exists on prevention, appropriate strategies and outcome of various treatment methods. The efficacy of ergonomic job analysis and acupuncture in the prevention and treatment of mild to moderate CTS among industrial workers appears not to have been widely investigated.

Objectives: These case studies assessed the short-term effects of acupuncture treatment and application of ergonomic job analysis in the management of carpal tunnel syndrome among industrial workers.

Methods: Subjects for this study were three industrial workers with a diagnosis of CTS of more than 3 months duration. Ergonomic work analysis was carried out to analyze and prescribe corrective measures for musculoskeletal and postural load in the subjects’ area of works. In addition to ergonomic job intervention, subjects underwent acupuncture treatment twice weekly for 8 weeks. The clinical symptoms of CTS was assessed using global symptom score (GSS) at baseline and at 8 weeks (after the intervention). Thus the main outcome measures used were GSS scores and ergonomic job analysis worksheet.

Results:   All the subjects in this study completed the 8 week intervention and were evaluated for pain, weakness, numbness and frequency of wakening up at night and Paresthesia.  The 3 subjects showed improvement with recovery from symptoms at the end of treatment at 8 week. Two of the three participants reported more than 80% reductions in pain intensity while one of the three reported complete recovery (100%) from pain. Numbness and paraesthesia were reportedly reduced by not less than 50% at the end of 8 week treatment in all the subjects. One of the participants recorded 85% (highest) reduction in the overall GSS scores while another recorded 75% reduction (lowest) at the end of 8 week treatment. Two of the three participants also showed complete recovery from the weakness in hand grip strength due to CTS. Frequency of wakening up at night was reduced to zero in all the three participants.


Conclusions: Findings from this study indicated that the acupuncture and application of ergonomic job analysis improved the overall symptoms of carpal tunnel syndrome among industrial workers suffering with CTS.

KEYWORDS: Acupuncture, Carpal Tunnel Syndrome, Ergonomics, Global Symptom Score, Physiotherapy


cupuncture, Carpal Tunnel Syndrome, Ergonomics, Global Symptom Score, Physiotherapy

Full Text:




Aigner N. Zöch G. Fialka A. 1998. Results of laser-acupuncture in carpal tunnel syndrome a prospective; randomised and blinded study. Focus on Alternative and Complementary Therapies 3(4): 180.

Akalin, E. and El, O 2002. "Treatment of carpal tunnel syndrome with nerve and tendon gliding exercises." Am J Phys Med Rehabil 81(2): 108-13.

Asghar A.U. Green G. Lythgoe M.F. Lewith G. MacPherson H. 2010. Acupuncture needling sensation: the neural correlates of deqi using fMRI. Brain Res; 1315: 111-8.

Atroshi I. Johnsson R. Sprinchorn A. 1998 Self-administered outcome instrument in carpal tunnel syndrome. Reliability, validity and responsiveness evaluated in 102 patients. Acta Orthopaedica Scandinavica ; 69(1):82-8.

Bekkelund, S. C. Pierre-Jerome A. 2001. "Impact of occupational variables in carpal tunnel syndrome." Acta Neurologica Scandinavica 103: 193-97.

Bland J.D. 2007 Carpal tunnel syndrome. BMJ 335(7615): 343-6.

Chang M.H. Ger L.P. Hsieh P.F. Huang S.Y. 2002 A randomised clinical trial of oral steroids in the treatment of carpal tunnel syndrome: a long term follow up. J Neurol Neurosurg Psychiatry 2002; 73(6): 710-4.

Chapell, R. W. and Bruening, A. 2003. Diagnosis and treatment of worker-related musculoskeletal disorders of the upper extremity. Evidence Report/Technology Assessment Number 62. Rockville, MD, Agency for Healthcare Research and Quality

Davis P. J. Hulbert A. 1998. "Comparative efficacy of conservative medical and chiropractic

treatments for carpal tunnel syndrome: a randomized clinical trial." Journal of Manipulative and

Physiological Therapeutics 21(5): 317-26.

Ebenbichler, G. K. and Resch A.1998. "Ultrasound treatment for treating the carpal tunnel syndrome: randomised "sham" controlled trial." BMJ 316: 731-35.

Ernst E. 2009 Acupuncture: what does the most reliable evidence tell us? J Pain Symptom Manage 37(4): 709-14.

Freedman J 2002. Acupuncture for carpal tunnel syndrome. Acupunct Med ; 20(1): 39-40.

Keith M.W. Masear V. Chung K. Maupin K. Andary M. Amadio P.C. 2009. Diagnosis of carpal tunnel syndrome. JAm Acad Orthop Surg ; 17(6): 389-96

Kumnerddee W. and Kaewtong A. 2010. Efficacy of acupuncture versus night splinting for carpal tunnel syndrome: a randomized clinical trial. J Med Assoc Thai; 93(12): 1463-9.

MacPherson H. White A. Cummings M. 2002. Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. J Altern Complement Med..

Maghsoudipour M. Moghimi S. Dehghaan F. Rahimpanah A. 2008 Association of occupational and non-occupational risk factors with the prevalence of work related carpal tunnel syndrome. J Occup Rehabil. Jun;18(2):152–6.

Margaret I.B.1990:Ergonomics: The physiotherapist in the work place Churchill living stone, 1st edition 101-111

Napadow V. Kettner N. Liu J. Li M. Kwong K.K. Vangel M. 2007. Hypothalamus and amygdala response to acupuncture stimuli in Carpal Tunnel Syndrome. Pain ; 130(3): 254-66.

Nathan P. R. Keniston,A. 1992. "Obesity as a risk factor for slowing of sensory conduction of the median nerve in industry." JOM 34(4): 379-83

Naeser M.A. Hahn K.A. Lieberman B.E. Branco K.F. 2002. Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: A controlled study. Arch Phys Med Rehabil; 83(7): 978-88.

O'Connor D. Marshall S. Massy-Westropp N. 2003. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev ; (1): CD003219.

Oztas, O.B. and Turan A. 1998. "Ultrasound therapy effect in carpal tunnel syndrome." Arch

Phys Med Rehabil 79: 1540-44.

Palmer K.T. Harris E.C. Coggon D. 2007. Carpal tunnel syndrome and its relation to occupation: a systematic literature review. Occup Med (Lond) ; 57(1): 57-66

Rozmaryn L. S. and Dovelle A. 1998. "Nerve and tendon gliding exercises and the conservative

management of carpal tunnel syndrome." J Hand Ther 11: 171-79.

Schulman R.A. Liem B. Moroz A. 2008. Treatment of carpal tunnel syndrome with medical acupuncture. Medical Acupuncture ; 20(3): 163-7.

Sim H. Shin B.C. Lee M.S. Jung A. Lee H. Ernst E. 2011. Acupuncture for carpal tunnel syndrome: a systematic review of randomized controlled trials. J Pain; 12(3): 307-14.

Szabo, R. 1998. "Acute carpal tunnel syndrome." Hand Clinics 14(3): 419-29.

Tsukayama H. Yamashita H. Kimura T. 2006 Factors that influence the applicability of sham needle in acupuncture trials: two randomized, single-blind, crossover trials with acupuncture-experienced subjects. Clin J Pain. ;22: 346–349

Waersted M. Bjorklund R. Westgard R. 1986 Generation of muscle tension related to a demand of continuing attention, Scientific conference on Work with display unit, Stockholm

Walker, W. and Metzler A. 2000. "Neutral wrist splinting in carpal tunnel syndrome: a

comparison of night-only versus full-time wear instructions." Arch Phys Med Rehabil 81: 424-29

Weinstein A. Pan J. Richardson P. A. 2003 controlled pilot trial of acupuncture for carpal tunnel syndrome. Clin Acupunct Orient Med; 4: 48.

Weintraub M. and Cole S. 2000. "Neuromagnetic treatment of pain in refractory carpal tunnel

syndrome: an electrophysiological and placebo analysis." Journal of Back and Musculoskeletal

Rehabilitation 15: 77-81

WHO 1985. Identification and control of work-related diseases. Report of a WHO Expert Committee. Technical Report Series 714. Geneva, World Health Organization.

Wong S. A. and Hui A. 2001. "Local vs systemic corticosteroids in the treatment of carpal tunnel

syndrome." Neurology 56: 1565-67.

World Health Organization (2002). Acupuncture: Review and Analysis Reports on Controlled Clinical Trials. Geneva: WHO; .

Yang C.P. Hsieh C.L. Wang N.H. Li T.C. Hwang K.L. Yu S.C. 2009. Acupuncture in patients with carpal tunnel syndrome: A randomized controlled trial. Clin J Pain ; 25(4): 327-33.

Yang C.P. Wang N.H. Li T.C. Hsieh C.L Chang H.H. Hwang K.L. 2011. A randomized clinical trial of acupuncture versus oral steroids for carpal tunnel syndrome: a long-term follow-up. J Pain 2011; 12(2): 272-9.


  • There are currently no refbacks.