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Show Notes

Carpal tunnel is one of those conditions I see all the time in clinic — especially in people who do repetitive wrist work, and noticeably more often in women. The stats are striking: lifetime risk peaks in the 45–60 age group, and only about 10% of patients are under 31. Women are 3–10 times more likely than men to get CTS — largely because anatomically the carpal tunnel tends to be narrower.

If you’ve ever woken up at night with numb, tingly fingers and had to “shake your hand” to get relief, you know how disruptive this is. Let’s look at carpal tunnel from both Western and TCM perspectives, and then cover practical treatment and prevention strategies you can use tomorrow.

What Is Carpal Tunnel? (Western View — simple and practical)

Definition: Compression of the median nerve as it passes through the carpal tunnel at the wrist.

Symptoms

• Numbness & tingling in thumb → index → middle → half ring finger (pinky usually spared)

• Weak grip, dropping objects, difficulty with fine motor tasks

• Symptoms often worse at night

• Pain can radiate up the forearm

Common causes

• Repetitive wrist motions (typing, assembly work, musicians)

• Pregnancy-related fluid retention

• Arthritis, hypothyroidism, diabetes

• Wrist fractures or injuries

• Anatomical narrow tunnel (genetic/anatomical)

Conventional treatments

• Splints (especially worn overnight) — helpful in mild early cases

• Physiotherapy & nerve gliding exercises

• Corticosteroid injections (symptom relief for many, but often temporary)

• Surgery (carpal tunnel release) — high success for severe/compressive cases, but carries surgical risks

Clinical note: Wrist splints can help 60–70% of early sufferers. Steroid injections work for many but symptoms can recur. Surgery is effective for severe entrapment or persistent weakness.

TCM View: how the channels explain CTS

In TCM we describe CTS as blocked flow (Qi & Blood stagnation) in channels that pass through the wrist. The Pericardium, Lung and Large Intestine channels traverse the carpal tunnel region, and when Qi/Blood stop moving you get numbness, tingling and pain.

Common TCM patterns seen with CTS

• Qi & Blood stagnation — especially after repetitive strain or trauma

• Dampness obstructing channels — often with swelling, heaviness

• Spleen Qi deficiency — poor fluid transformation leads to damp accumulation

• Chronic/degenerative cases: Kidney or Liver Yin/Blood deficiency → chronic numbness and weakness

A simple image I use for students: think of the wrist like a roadway — if traffic (Qi & Blood) stalls, the “cars” (nerve signals) get delayed and symptoms appear.

Acupuncture approach: local + distal + root

Effective TCM treatment combines local release with distal support and addressing the root pattern.

Local points (for immediate pain relief & local unblock)

• PC7 — local, strong for wrist pain & median nerve area

• PC6— local wrist point; also calms the Shen

• LI5— local large-intestine channel at wrist

• Baxie — for hand/wrist pain/tingling

Distal & channel-supporting points (address root & circulation)

• SJ5 — opens San Jiao channel, helps wrist/forearm

• LI4 + LV3 — “Four Gates” to move Qi and Blood systemically

• LI10 — supports forearm/arm function

• LI11 — clears heat and moves Qi/Blood (useful if inflammation present)

• ST36, SP6 — tonify Qi & Blood if deficiency underlies chronic cases

How to combine

• Typical strategy: local points (PC7, PC6, Baxie) + Four Gates (LI4/LV3) + ST36 if general tonification required.

• Add moxa if cold-damp pattern is suspected; cupping or gua sha along forearm extensors can help break adhesions.

Needle technique & frequency

• Use a mix of local shallow needling and distal strong-reinforcing/dispelling techniques.

• Consider electroacupuncture across the carpal tunnel for severe pain/nerve irritation (clinically helpful in many cases).

• Frequency: 1–2×/week initially; adjust based on response. Chronic cases benefit from a longer course with tapering.

Safety note: If a patient has progressive motor weakness or thenar muscle wasting, refer for nerve conduction studies and consider surgical consultation — acupuncture is valuable but not a replacement for urgent care in severe compression.

Herbal & adjunctive TCM tools

Herbal formulas (tailor to pattern)

• Qi & Blood stasis: Xue Fu Zhu Yu Tang (or modifications) to move blood and relieve blockage

• Dampness obstruction: herbs that drain damp/transform phlegm like Yi Yi Ren modifications

• Chronic numbness from deficiency: nourishing formulas to build Yin/Blood (customized by pattern)

Adjuncts

• Cupping along the forearm extensor group to increase local circulation

• Tui Na / gentle mobilization and tendon gliding to reduce adhesions

• Moxa if cold-damp pattern (warm and mobilize)

• Topical liniments (e.g., warming herbal plasters) can be soothing between sessions

Western-friendly adjuncts & supplements I recommend in clinic

• Ergonomic splinting at night (short-term while starting TCM therapy)

• Magnesium for muscle relaxation (if appropriate)

• Omega-3s / anti-inflammatory diet to reduce systemic inflammation

• Turmeric/curcumin or ginger as dietary anti-inflammatories (check for contraindications)

Diet, lifestyle & prevention (practical takeaways)

Ergonomics

• Keyboard height & wrist posture: neutral wrist alignment, avoid wrist extension

• Use wrist rests and split keyboards if needed

• Frequent micro-breaks: 5–10 minutes every hour, with wrist stretches

Hand & wrist mobility

• Gentle nerve gliding and tendon-gliding exercises daily

• Wrist rotations, fist/extension cycles, wall push-ups for mobility

Work modifications

• Alternate tasks to avoid constant repetitive strain

• Reduce forceful grip tasks where possible

Diet

• Avoid greasy, sugary foods that promote dampness in TCM terms

• Emphasize anti-inflammatory foods: fish, ginger, turmeric, leafy greens, hydration

A simple clinic protocol example (starter plan)

Acute mild CTS

• Night splinting + acupuncture 1×/week for 4–6 weeks

• Local points: PC7, PC6, Baxie + distal LI4/LV3

• Add cupping on forearm extensors if tight

Moderate/recurrent CTS

• Acupuncture 1–2×/week for 6–12 weeks

• Electroacupuncture across carpal tunnel if pain predominant

• Herbs as indicated (stasis or damp formula), ergonomic work reassessment

Chronic severe CTS with muscle weakness

• Urgent referral for nerve conduction test/surgical consult + supportive TCM care pre- and post-op

Final thoughts

Carpal tunnel is a common, often treatable condition. From a TCM lens it’s a traffic jam in the wrist channels — and between acupuncture (local + distal), movement therapy, herbs when needed, and sensible ergonomic care, most people can find meaningful relief without defaulting to prolonged waiting or immediate surgery. That said, quick referral is essential if there’s progressive motor loss.

Disclaimer

The Acupro Show podcast and material shared through Acupro Academy is a subdivision of Natural Health Sense Incorporated. Designed solely for educational and entertainment purposes. The utilization of information from this podcast or any associated material is at the user’s discretion and risk. This content is not meant to replace the guidance of an acupuncturist. Nor Chinese medicine doctor, medical doctor, physician, or any qualified professional. It is not a substitute for proper diagnosis or treatment. As well as users are strongly advised not to ignore or postpone seeking medical advice. For any existing medical condition with their healthcare professional. Regarding any health concerns.

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