Skip to main content

Main menu

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Current Issue
  • Content
    • Current Issue
    • Early Access
    • Multimedia
    • Podcast
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • Plain Language Summaries
    • Calls for Papers
  • Info for
    • Authors
    • Reviewers
    • Job Seekers
    • Media
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • Podcast
    • E-mail Alerts
    • Journal Club
    • RSS
    • Annals Forum (Archive)
  • Contact
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
Review ArticleSystematic Reviews

What Can Family Physicians Offer Patients With Carpal Tunnel Syndrome Other Than Surgery? A Systematic Review of Nonsurgical Management

Felicity Goodyear-Smith and Bruce Arroll
The Annals of Family Medicine May 2004, 2 (3) 267-273; DOI: https://doi.org/10.1370/afm.21
Felicity Goodyear-Smith
MB, ChB, MGP
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Bruce Arroll
MB, ChB, PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading

Published eLetters

If you would like to comment on this article, click on Submit a Response to This article, below. We welcome your input.

Submit a Response to This Article
Compose eLetter

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.

Vertical Tabs

Jump to comment:

  • Laser Acupuncture and Microamps TENS, Controlled Study and Open Protocol Study
    Margaret A Naeser
    Published on: 02 June 2004
  • Published on: (2 June 2004)
    Page navigation anchor for Laser Acupuncture and Microamps TENS, Controlled Study and Open Protocol Study
    Laser Acupuncture and Microamps TENS, Controlled Study and Open Protocol Study
    • Margaret A Naeser, Boston

    I have published two papers utilizing laser acupuncture (and microamps TENS) to treat mild-moderate Carpal Tunnel Syndrome, which were not included in the Goodyear-Smith & Arroll, 2004, review of nonsurgical management of CTS:

    Naeser MA, Hahn K-A K, Lieberman BE, Branco KF. Carpal Tunnel Syndrome Pain Treated with Low-Level Laser and Microamps TENS, A Controlled Study. Archives of Physical Medicine and Reh...

    Show More

    I have published two papers utilizing laser acupuncture (and microamps TENS) to treat mild-moderate Carpal Tunnel Syndrome, which were not included in the Goodyear-Smith & Arroll, 2004, review of nonsurgical management of CTS:

    Naeser MA, Hahn K-A K, Lieberman BE, Branco KF. Carpal Tunnel Syndrome Pain Treated with Low-Level Laser and Microamps TENS, A Controlled Study. Archives of Physical Medicine and Rehabilitation, 2002;83:978-988.

    Branco K, Naeser MA. Carpal tunnel syndrome: Clinical Outcome After Low-Level Laser Acupuncture, Microamps Transcutaneous Electrical Nerve Stimulation, and Other Alternative Therapies - An Open Protocol Study. J Alternative and Complementary Med 1999; 5(1):5-26.

    The success rate (as defined by at least a 50% reduction in pain following the full series of real laser acupuncture and microamps TENS treatments) was 88%; a placebo response was observed in 27% of the patients (as defined by at least a 50% reduction in pain following the full series of sham laser acupuncture and microamps TENS treatments) (Naeser et al., 2002). All patients had been diagnosed with CTS using nerve conduction studies: mild CTS (sensory involvement) or moderate CTS (sensory and motor involvement, with motor latencies above 4.3 ms).

    In the open-protocol, acupuncture office study, the success rate was 92% (Branco & Naeser, 1999).

    Patients with severe CTS (abnormal EMG) are not appropriate candidates for this conservative, nonsurgical treatment. However, in these patients with severe CTS, if pain persists following surgical release of the transverse carpal ligament, laser acupuncture with microamps TENS is appropriate (Branco & Naeser, 1999).

    Website which describes the Naeser et al., (2002) study, and shows a supplemental home treatment program, including photographs of the program:

    http://gancao.net/ht/cts.shtml

    For more general information on low-level laser acupuncture:

    http://gancao.net/ht/laser.shtml

    Patients with mild-moderate CTS who wish to be treated with this alternative treatment may contact the Am. Assoc. of Oriental Medicine, for referral to a Licensed Acupuncturist who has been trained in laser acupuncture (1-888-500-7999).

    It is suggested that this method be used early into the course of CTS, preferably within the first 6 to 12 months of symptom onset, although it may be effective in cases with CTS history of several years. A treatment course of three treatments per week (every other day) for 5 weeks (15 treatments) is recommended.

    The abstract for the controlled study (Naeser et al., 2002) is copied below.

    Objective: To investigate whether real or sham, low-level laser therapy (LLLT) plus microamps TENS applied to acupuncture points significantly reduces pain in carpal tunnel syndrome (CTS).

    Design: Randomized, double-blind, placebo control, crossover trial. Patients and staff administering outcome measures, blinded.

    Setting: Outpatient, V.A. hospital, university-affiliated.

    Patients: Eleven mild-moderate CTS cases (nerve conduction study, clinical exam) who failed standard medical or surgical treatment for 3-30 months.

    Intervention: Patients received real and sham treatment series (each for 3-4 weeks), order randomized. Real treatments used red-beam laser (continuous wave, 15 mW, 632.8 nm) on shallow acupuncture points on affected hand; infrared laser (pulsed, 9.4W, 904 nm) on deeper points on UE and cervical paraspinal areas; and microamps TENS on affected wrist. Devices were painless, non-invasive and produced no sensation whether real or sham. Hand treated behind hanging black curtain without patient knowing if devices were turned on (real) or off (sham).

    Main Outcome Measures: Melzack pain score, sensory and motor latencies, Phalen and Tinel signs.

    Results: Significant decreases in Melzack pain score, median nerve sensory latency, Phalen sign and Tinel sign, Post-real treatment series but not Post-sham. Patients able to perform prior work (computer typist, handyman) and stable for 1-3 years.

    Conclusions: This new, conservative treatment was effective to treat CTS pain in this study, larger studies are recommended.

    Competing interests:   None declared

    Show Less
    Competing Interests: None declared.
PreviousNext
Back to top

In this issue

The Annals of Family Medicine: 2 (3)
The Annals of Family Medicine: 2 (3)
Vol. 2, Issue 3
1 May 2004
  • Table of Contents
  • Index by author
  • TRACK Participants
  • The Issue in Brief
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
What Can Family Physicians Offer Patients With Carpal Tunnel Syndrome Other Than Surgery? A Systematic Review of Nonsurgical Management
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
9 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
What Can Family Physicians Offer Patients With Carpal Tunnel Syndrome Other Than Surgery? A Systematic Review of Nonsurgical Management
Felicity Goodyear-Smith, Bruce Arroll
The Annals of Family Medicine May 2004, 2 (3) 267-273; DOI: 10.1370/afm.21

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
What Can Family Physicians Offer Patients With Carpal Tunnel Syndrome Other Than Surgery? A Systematic Review of Nonsurgical Management
Felicity Goodyear-Smith, Bruce Arroll
The Annals of Family Medicine May 2004, 2 (3) 267-273; DOI: 10.1370/afm.21
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • INTRODUCTION
    • METHODS
    • RESULTS
    • DISCUSSION
    • Acknowledgments
    • Footnotes
    • REFERENCES
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Efficacy of splinting the wrist and metacarpophalangeal joints for the treatment of Carpal tunnel syndrome: an assessor-blinded randomised controlled trial
  • Sonographically Guided Percutaneous Needle Release of the Carpal Tunnel for Treatment of Carpal Tunnel Syndrome: Preliminary Report
  • In Vitro Optimization of Dexamethasone Phosphate Delivery by Iontophoresis
  • A Survey of Therapeutic Ultrasound Use by Physical Therapists Who Are Orthopaedic Certified Specialists
  • Author Response
  • Carpal tunnel syndrome and vitamin B6
  • Improving Health Care Locally and Globally
  • In This Issue: The Patient Voice, Clinical Research, Clustered Data, and the Wonca Research Conference
  • Google Scholar

More in this TOC Section

  • Potentially Inappropriate Prescribing Among Older Persons: A Meta-Analysis of Observational Studies
  • Accuracy of Signs and Symptoms for the Diagnosis of Acute Rhinosinusitis and Acute Bacterial Rhinosinusitis
  • Employment Interventions in Health Settings: A Systematic Review and Synthesis
Show more Systematic Reviews

Similar Articles

Subjects

  • Domains of illness & health:
    • Acute illness
    • Chronic illness
  • Other research types:
    • Professional practice

Content

  • Current Issue
  • Past Issues
  • Early Access
  • Plain-Language Summaries
  • Multimedia
  • Podcast
  • Articles by Type
  • Articles by Subject
  • Supplements
  • Calls for Papers

Info for

  • Authors
  • Reviewers
  • Job Seekers
  • Media

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2025 Annals of Family Medicine