Akupunktur bättre än steroider för karpaltunnelsyndrom
(Acupuncture better than steroids for carpal tunnel syndrome)
A group from Taiwan has demonstrated that short-term acupuncture treatment can result in long-term improvement in carpal tunnel syndrome (CTS) and that acupuncture produces significantly better results than oral steroid treatment. Seventy-seven patients with mild-to-moderate idiopathic CTS were randomised to either four weeks of either oral prednisolone or twice-weekly acupuncture sessions.
The patients were followed up at seven and 13 months using global symptom score (GSS) assessments and electrophysiological nerve conduction studies. Compared with baseline levels, the percentages of patients who showed treatment failure, moderate improvement and good improvement were significantly different between the two groups in favour of acupuncture, at both month seven (10.5, 2.6 and 86.8% acupuncture vs 33.3, 7.7, and 59% steroids) and month 13 (15.8, 2.6 and 81.6% acupuncture vs 51.3, 0 and 48.7% steroids).
The acupuncture group showed a significantly better improvement in GSS, distal motor latencies and distal sensory latencies compared to the steroid group throughout the one-year follow-up period. Significant correlation was observed between changes of GSS and all but one of the electrophysiological parameters. (A Randomized Clinical Trial of Acupuncture Versus Oral Steroids for Carpal Tunnel Syndrome: A Long-Term Follow-Up. J Pain. 2010 Nov 24. [Epub ahead of print]).
A systematic review and meta-analysis evaluating the effectiveness of acupuncture and acupuncture-like treatments for CTS carried out by Korean authors has concluded that the evidence for acupuncture as a symptomatic therapy for CTS is encouraging, but not convincing. Six RCTs met their inclusion criteria, and a meta-analysis of acupuncture versus steroid injection therapy favored acupuncture in terms of responder rate.
The methodological quality of the reviewed studies was assessed as generally being low and the authors called for further rigorous studies to establish the therapeutic value of acupuncture for this condition. (Acupuncture for Carpal Tunnel Syndrome: A Systematic Review of Randomized Controlled Trials. J Pain. 2010 Nov 17. [Epub ahead of print]).