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Laser Acupuncture for Carpal Tunnel Syndrome

By Dr. Margaret A. Naeser

If you suffer from carpal tunnel syndrome, you'll be happy to discover that a new therapy has recently been researched with optimistic results. The key strength of this therapy is that it can be performed at home by the patient.

About Carpal Tunnel Syndrome

  • Definition of Carpal Tunnel Syndrome (CTS)
  • Current Treatment for Carpal Tunnel Syndrome

Carpal Tunnel Syndrome Laser Acupuncture Research

  • The Purpose of this Research Project
  • Method used in this Research Project
  • Results from this Research Project
  • Status of Funding for this Research Project
  • Conclusions and Summary for Future Research
  • Case Examples of some Patients with CTS who were Treated with Laser Acupuncture and Microamps TENS Utilizing this Research Protocol

"The Naeser Laser Home Treatment Program"

The Cost of Carpal Tunnel Syndrome

  • Current Cost Estimates to Treat Carpal Tunnel Syndrome in the U.S.
  • Potential Cost Savings with use of this Treatment Program
  • Proposed Definition of Work-Related Carpal Tunnel Syndrome National Institute of Occupational Safety and Health (NIOSH) (Matte et al., 1989)
  • Potential Cost Savings with Laser Acupuncture and Microamps TENS Treatments for Carpal Tunnel Syndrome

Source Material

  • References
About Dr. Margaret A. Naeser

This information is provided in response to a request from the public for information on availability of an alternative therapy to treat the painful symptoms of Carpal Tunnel Syndrome (CTS) or Repetitive Strain Injury (RSI). It is not intended to replace medical advice.

The "Naeser Laser Home Treatment Program for the Hand ©" is an alternative therapy designed to help treat the painful symptoms of CTS or RSI (Naeser & Wei, 1994, p. 40). This treatment program has undergone a controlled research study through Boston University School of Medicine and the V.A. Boston Healthcare System (Naeser, Hahn & Lieberman, 1996).

The "Naeser Laser Home Treatment Program for the Hand ©" utilizes a red-beam laser lecture pointer (laser pen), and a microamps TENS device (painless transcutaneous electric nerve stimulation) to stimulate acupuncture points on the wrist and fingers (no needles). The small, red-beam laser pen is a 5 mW, ITO laser pen, with a fixed "on/off" switch. The red-beam laser light coming from the laser pen is similar to the red-beam laser light coming from the check-out scanner at grocery stores - i.e., no significant risk when used properly (i.e. not staring directly into the laser beam). The small, lightweight, microamps TENS device is the MicroStim 100 TENS. It is highly portable and fits into a shirt pocket. (More information is provided on these devices, later.) It is thought that these devices may have an anti-inflammatory effect on the painful area where they are applied to the skin.

Thus far, six out of six patients who completed the treatment program were all able to resume previous work activities without any pain, following four weeks of treatments. The treatments were administered 3 times a week (every other day), for 4 weeks. Each treatment lasted about 45 minutes.

The patients had had wrist/hand pain which ranged in duration of from 2 months to 12 years. The patient with pain of 12 years' duration had already had surgery performed on the right hand, 12 years earlier, and he still had residual pain there. Plus, he had new pain in the left hand of 2 years' duration. The laser acupuncture and microamps TENS treatments completely alleviated the pain in the right and left hands, and he was able to return to work as a handyman, without pain. The other 5 patients (secretaries and a doctoral graduate student) had computer-keyboard-related types of pain. All were able to resume keyboard typing and transcription work, without pain, after four weeks of treatments.

In two patients, at one year after cessation of the treatments, some mild hand pain recurred. Each patient was able to treat herself at home, and in two weeks, the pain was again completely gone, and has not returned. Thus, one advantage of this treatment program is that the pain can be totally managed by the patient, him/herself at home.

This type of home treatment appears to be more appropriate for CTS patients who have mild to moderate levels of wrist/hand pain, where there has been no atrophy of the thumb muscles. In more severe cases, surgery may be more appropriate and such decisions should be made in consultation with a physician.

About Carpal Tunnel Syndrome

Definition of Carpal Tunnel Syndrome (CTS)

Carpal Tunnel Syndrome (CTS) is an entrapment neuropathy of the median nerve at the wrist (Rosenbaum & Ochoa, 1993). In other words, the nerve that travels from one's arm to parts of the hand gets entrapped within the carpal tunnel. The carpal tunnel consists of some tissues (the transverse carpal ligament and 9 flexor tendons) that surround the median nerve as it passes through the wrist and palm area. If this median nerve gets compressed due, in part, to a repetitive stress, such as typing, then carpal tunnel syndrome is one disorder that may result.

Thus, CTS occurs when there is chronic pressure on the median nerve in the wrist area. Patients with CTS go to the doctor with pain in the wrist that radiates into the hand, and sometimes into the forearm; numbness and tingling in the thumb, index, and middle fingers; and weakness in the hand.

CTS occurs more commonly in workers whose tasks involve repetitive hand movements including computer keyboard operators. CTS is a particularly severe example of Repetitive Strain Injury (RSI).

A proposed definition of work-related CTS from the National Institute of Occupational Safety and Health (NIOSH) is provided in Table 1 (Matte et al., 1989). Patients who participate in this research project meet these NIOSH criteria for the diagnosis of CTS.

In 1988, the incidence of CTS was estimated to be 515 per 100,000 population (Occupational Disease Surveillance, 1989). Thus, it was estimated there were 1.3 million cases. In 1995, the U.S. National Center for Health Statistics estimated there were over 1.89 million cases of CTS in the U.S. Other debilitating forms of RSI are even more prevalent.

Current Treatment for Carpal Tunnel Syndrome

In work-related CTS, a trial of abstinence from activities which incite the symptoms is tried, as well as analysis of work habits and tools (Feldman et al., 1987). The goal is to decrease exposure to provocative actions through patient education, as well as through appropriate ergonomic changes in the worksite area. The wrist may be splinted in a neutral position, especially at night and during activities that aggravate the symptoms.

Direct injection of steroids into the carpal tunnel may provide only temporary relief. After 2 to 4 months, between 65 and 90% of patients can be expected to have recurrence of symptoms (Slater, Jr. & Bynum, 1993). In one study, at 18 months after steroid injection, only 22% of patients were still free of symptoms (Gelberman, Aronson, Weisman, 1980).

In another study, only 11% of cases treated with steroid injection had permanent relief and these were the mildest cases in the series (Goodman & Foster, 1962). Operative release of the transverse carpal ligament is performed in approximately 40% of CTS cases, followed by a 2-3 month period of rehabilitation.

Carpal Tunnel Syndrome Laser Acupuncture Research

The Purpose of this Research Project

The purpose of this research project is to investigate whether red-beam low-energy laser and microamps TENS (painless transcutaneous electric nerve stimulation) can be used to stimulate acupuncture points on the hand, to treat the painful symptoms of CTS, under controlled research conditions. This research project uses a painless, non-invasive, non-surgical technique, which can also be applied by the patient him/herself, at home.

Method used in this Research Project

In the controlled research at the hospital, the patient's hand is treated behind a black curtain, and the patient does not know whether the laser beam and TENS devices are "on or off," because each device produces no feeling. The research at the hospital is a randomized, double-blind, placebo-controlled, cross-over design. There, patients receive 3 treatments per week (every other day), with 12 real and 12 sham treatments (each for 4 weeks), order randomized. Pre- and post-testing are performed with objective and subjective tests. These tests include nerve conduction studies; Melzack pain questionnaires; and hand strength and dexterity testing which are performed by hospital staff blind as to the treatment condition (real or sham).

In the controlled research at the hospital, various lasers are used, but limited space here does not permit discussion of all lasers. Some of these larger lasers include a 15 mW red-beam, helium neon laser, Dynatronics Model 1620; or a 50 mW infrared-beam, diode laser, 830 nm wavelength, Dynatronics Model 1650.

The laser used in the Home Treatment program is described later, under "The Naeser Laser Home Treatment Program for the Hand ©."

Results from this Research Project

As of November, 1996, seven patients had completed the treatment under controlled research conditions at the hospital. These seven patients had significant reduction in pain scores after the series of real treatments, but no significant reduction in pain scores after the series of sham treatments. Following the real treatment condition, the Melzack pain scores were significantly reduced (p <.02). For example, before the real treatments were started, the average pain score was 17.3 points (S.D., 10.3). After the real treatments were finished, the average pain score was only 5.4 points (S.D., 6.9). Following the sham treatment condition where the lasers and microamps TENS devices were taped into place on the patient's hand (but not turned on), the Melzack pain scores were not significantly reduced. Before the sham treatments were started, the average pain score was 16.9 points (S.D., 12.2). After the sham treatments were finished, the average pain score was 11.0 (S.D., 11.8).

Also, these seven patients treated under controlled research conditions at the hospital, had significant improvement in their nerve conduction studies after the series of real treatments, but no significant improvement in their nerve conduction studies after the series of sham treatments. Following the real treatment condition, the sensory latency of the median nerve across the wrist was significantly reduced (p <.05). In the real condition, five of the seven patients showed improved, shorter latencies following treatment; two patients showed no change. Before the real treatments were started, the average median nerve sensory latency was 4.8 msec (S.D., 1.3). After the real treatments were finished, the average sensory latency was 4.5 msec (S.D., 1.3). Following the sham treatment condition, the sensory latency of the median nerve across the wrist was not significantly reduced. In the sham condition, data were available for only six patients. Following sham treatment, only two of the six patients showed improved, shorter latencies; three patients showed no change and one patient showed an increased, longer latency. Before the sham treatments were started, the average median nerve sensory latency was 4.7 msec (S.D., 1.2). After the sham treatments were finished, the average median nerve sensory latency was 4.4 msec (S.D., 1.1).

All patients were able to resume prior work activities with less, or no pain, including keyboard typing, handyman work (cement laying, electrical wiring), and plumbing. At one year follow-up, one patient (who was diabetic and had had a stroke), had a return of hand pain.

These data indicate that after the series of real treatments, there was a significant reduction in pain, and the function of the sensory aspect of the median nerve became significantly "closer to normal." These significant changes were not observed following the series of sham treatments. Hence, it appears that the treatments with the real laser and microamps TENS devices are promoting a positive change in the patient's condition (not observed with the sham devices), and the placebo effect is being controlled for.

Three other cases were treated in an open protocol with the Naeser Laser Home Treatment Program for the Hand using the 5mW laser pen, and MicroStim 100 TENS device at home. All resumed prior type of work (computer keyboard typing and transcription work) without pain after 4 weeks.

We presented a research paper on the first six patients at the 16th Annual Meeting of the American Society for Laser Medicine and Surgery, Inc., Orlando, FL, April 15, 1996 and the paper was one of 12 papers nominated for "Best Clinical Award." The research will continue.

Status of Funding for this Research Project

This research project is unfunded at this time, and we are seeking research funds (especially from companies), so that many more patients with CTS and RSI pain can be studied and treated. Any companies who would be interested in funding this research should contact Dr. Naeser through the American Association of Oriental Medicine (AAOM), 433 Front Street, Catasauqua, PA 18032-2506; telephone (610) 266-1433.

All equipment (lasers and microamps TENS devices) are currently donated by the companies which produce them. The lasers are donated by the

  • Dynatronics Research Corporation, 7030 Park Center, Salt Lake City, Utah 84121; 1-800-874-6251.
The MicroStim 100 TENS devices are donated by
  • MicroStim, Inc., 7881 NW 90th Avenue, Tamarac, FL 33321; 1-800-326-9119, or (954) 720-4383.
All acupuncture treatments are provided by volunteer licensed acupuncturists at the hospital.

Conclusions and Summary for Future Research

Conclusions from this pilot study are that research should continue. If this treatment protocol is successful in relieving the painful symptoms of CTS, then workers who have CTS can be treated at home, in approximately four weeks (without medications or surgery) and return to work in a more timely manner, at a much lower cost.

Case Examples of some Patients with CTS who were Treated with Laser Acupuncture and Microamps TENS Utilizing this Research Protocol

PATIENT #1.

G.M., a 40 year old man who had wrist pain in the right hand, for 3 months prior to Laser Acupuncture and Microamps TENS treatments under controlled research conditions at the hospital.

Treated with research protocol in January and February '94, and March '95. Melzack pain score was 24 before treatment; 26, after sham treatment, and 0, after real treatment. Works now as a Computer Information Systems Administrator, at a major university in the Boston area. Able to resume all computer keyboard work for 8 - 10 hours a day, without pain.

PATIENT #2

L.P., a 46 year old man who had wrist pain in the right hand for 12 years, following surgical release of the carpal tunnel on the right hand; and new wrist pain in the left hand for 2 years. He did not want to have surgery again. He received Laser Acupuncture and Microamps TENS treatments under controlled research conditions at the hospital.

Both hands were treated with this research protocol in October, November, and December '94. Melzack pain score in the right hand was 16 before treatment; 0, after real treatment. This was the hand with post-surgical pain for 12 years. Pain score in the left hand was 23 before treatment, and 0, four weeks later, after real treatment; and still 0, four weeks later, after sham treatment. Able to resume handyman work all day (laying cement steps, electrical wiring, painting, etc.), without pain.

PATIENT #3. E.R.

E.R., a 59 year old woman who had wrist pain in the right hand for 2 years, prior to Laser Acupuncture and Microamps TENS treatments under controlled research conditions at the hospital. She has diabetes. Steroid injections or surgery are to be avoided, if possible, with diabetic patients, due to possible problems with wound healing.

Treated with this research protocol in November and December '94, and January '95. Melzack pain score was 23 before treatment; 9, after real treatment, and 0, four weeks later, after sham treatment. This pain score of 0 after the sham treatment could represent a final placebo effect, or a "delayed effect" from the real laser treatments. We do not know. Prior to treatment, she stated that she was "Crippled for the day, if wrote for one hour." After treatments completed, "Able to type all day." Note: After 2 months following completion of research treatments, however, some pain returned (Melzack pain score of 16). The patient then treated herself at home with the 5 mW red-beam laser pen, and after two weeks of home treatment, the pain returned to zero.


"The Naeser Laser Home Treatment Program"

"The Naeser Laser Home Treatment Program for the Hand ©"

A general description of this treatment program is provided here. A more detailed description of this treatment program is available in a booklet available from the American Association of Oriental Medicine (AAOM). The AAOM can also help a patient to locate a licensed acupuncturist, who can help train the patient in the home treatment program. Information on how to order this booklet, "Naeser Laser Home Treatment Program for the Hand ©," and how to locate a licensed acupuncturist, is provided at the end of this report.

Two devices are used in the home treatment program:

  • a red-beam laser pen (5 mW, ITO laser pen) and
  • a microamps TENS device (MicroStim 100).
The 5 mW red-beam laser pen and the microamps TENS device are both used to stimulate wrist and hand acupuncture points.

Consumer warnings

For the Laser Pen:
  • Do not stare into the laser beam source, it would harm the retina. The laser lecture pointer is clearly labeled - "Do not stare into the laser beam."
  • Do not use the laser beam on pregnant women.

For the Microamps TENS Device:

  • Do not use on persons with a pacemaker.
  • Do not use on pregnant women.

Before beginning the treatment, the patient washes his/her hands, and wipes all areas on the hand to be treated, with alcohol. It is important that there is no perspiration or hand lotion present on the skin, because these would block the laser beam and microamps TENS stimulation of the acupuncture points. A substance with yellow color such as iodine, would also block the stimulation effects of the laser light.

Step 1.

The tip of the laser pen is physically placed onto the skin at the median nerve area on the wrist crease at the base of the palm (acupuncture point, Pericardium 7) for 21 minutes (7 joules of energy). See Photo #1. The laser pen is held in a 90 degree position, so that the laser beam is entering the acupuncture point at a perpendicular angle for maximum penetration. The "continuous wave" laser beam is used, not the "pulsating" laser beam. The actual depth of tissue penetration with a red-beam laser is believed to be only 0.8 mm (direct energy), and 11-15 mm (indirect energy) (Seitz & Kleinkort, 1986). Thus, the red-beam laser is ideally suited for stimulation of shallow acupuncture points located on the hand.

Step 2.

The primary electrode for the MicroStim 100 TENS device is taped onto the same area which was treated in Step 1 - e.g., the palm side of the wrist crease at the median nerve (acupuncture point, Pericardium 7). The primary electrode used with the MicroStim 100 TENS device is the metallic, circular-shaped electrode with four tiny LED red lights which are embedded into it; it is about the size of a fifty-cent coin. This primary electrode should be pre-moistened with some clear conducting gel before it is taped into place. Or, a clear, double-sided, self-sticking electrode patch may be used over the primary electrode. See Photos #2, #3, and #4. The grounding pad electrode is then pre-moistened with a few drops of water, and taped onto the back of the wrist area (acupuncture point, Triple Warmer 4).

The MicroStim 100 TENS device is turned on, and adjusted so that the patient does not feel any "tingling" sensation at all. For example, the intensity knob is turned up until a "tingling" sensation is felt at either electrode site, then the intensity is turned down, until there is no "tingling" sensation at all. This will be the ideal setting for treatment with microamps TENS for that patient, on that day. The ideal setting is usually around 200 to 500 microamps (around 2 to 4 or so, on the knob).

A high-frequency pulse rate of 292 Hz (F4) is used for two minutes, then the pulse rate is turned down to a low-frequency pulse rate of 0.5 Hz (F1), which is used for 18 minutes. A more detailed explanation of exactly how to use the MicroStim 100 TENS for this treatment protocol is provided in the booklet from the American Association of Oriental Medicine.

Step 3.

While the TENS device is in place at the wrist, the red-beam laser pointer is applied to other acupuncture points on the affected hand, 3 minutes per acupuncture point (1 joule per point). See Photos #5 and #6. The acupuncture points are as follows: Lung 11, Large Intestine 1, Pericardium 9, Triple Warmer 1, Heart 9, Small Intestine 1, Distal BaXie points in the webs between the fingers, Large Intestine 4, Pericardium 8, Heart 8, Lung 9 or 10, and Heart 7.

Each treatment lasts about 45 minutes. Each device produces no feeling whatsoever, no heat, no cold, no pain.

Additional acupuncture points may be treated on the forearm or up to the shoulder area, according to the distribution of possible radiating pain. It is extremely important to be trained by a licensed acupuncturist in the location of all acupuncture points. For example, an acupuncture paper published in 1990 observed complete pain relief in 24 of 36 cases with CTS (82% success rate), following a series of acupuncture treatments (Chen, 1990).

Frequently Asked Questions

1. Is it OK to continue to take non-steroidal anti-inflammatory medications (ibuprofen) while doing the Laser Acupuncture and Microamps TENS treatments?

  • Yes, but you may not need them after a few weeks. Ibuprofen does not interfere with these treatments. My anecdotal experience with patients taking cortisone, however, suggests that patients using this drug while undergoing acupuncture treatments will have a poor response to acupuncture or laser acupuncture. Additional medications which I have observed to be incompatible with good response are some seizure medications (Phenobarbitol or Tegretol), and some tranquilizers (Valium) and anti-depressants; or cases who have had Bo-Tox injection into the joint for control of spasms. Patients should always consult with their physician before making any changes in their medications.

2. Do I have to treat a minimum of every other day?

  • Yes. The minimum schedule for these Laser Acupuncture and Microamps TENS treatments is once every 48 hours, especially during the first two weeks. There was one additional patient (age 72) who was treated under the controlled research conditions at the hospital, but during the series of real treatments, his wife became ill, and he was only treated once or twice a week (the regular schedule is 3 times per week). This patient had only minimal change in his Melzack pain score (score of 24 Pre-real treatments, and score of 19, Post-real treatments). Daily treatments are the best treatment schedule, if possible, especially in the first two weeks.

How does Laser Acupuncture and Microamps TENS work?

The effects of low-energy laser biostimulation on the cellular level have been reviewed by Basford (1989). The mechanism of exactly how this treatment program with red-beam laser and microamps TENS stimulation works is unknown. However, there are some possible clues:

  • The red-beam laser is thought to have an anti-inflammatory effect (Mester, Toth, Mester, 1982), and may increase serotonin levels to promote pain relief (Walker, 1983).
  • In addition, the red-beam laser and the microamps TENS device may increase ATP levels (adenosine triphosphate) at the cellular level in the wrist and hand where they are used (Passarella et al., 1984; Passarella, 1988; Cheng et al., 1982). An increase in ATP levels would improve cellular metabolism locally, in the wrist and hand area, and help the injured area to return to normal.

How to Purchase this Equipment for Home Treatment

The 5 mW ITO laser lecture pen may be purchased from Lhasa Medical, Inc., 539 Accord Station, Accord, MA 02018-0539; 1-800-722-8775. It sells for $142.00

There are other laser lecture pens sold in the U.S. Some of these pens are also approximately 5 mW in power output. These other laser pens are often less expensive, but more difficult to use. Two additional vendors are: Damark, 7101 Winnetka Ave., N., P.O. Box 9437, Minneapolis, MN 55440-9437, 1-800-729-9000; and Edmund Scientific, 101 E. Gloucester Pike, Barrington, NJ 08007, (609) 547-3488.

The MicroStim 100 TENS device may be purchased from MicroStim, Inc., 7881 NW 90th Ave., Tamarac, FL 33321; 1-800-326-9119, or (954) 720-4383. It sells for $895.00 (most insurance companies will pay 80%, with a prescription from a physician).

There are many other types of red-beam laser pens, and microamps TENS devices available for purchase today, however the information which is provided here, is based only on treatment experience with these specific devices. No endorsement is made for these devices, however, and no medical claims are made for them.

The FDA considers low-level laser biostimulation to be "investigational." Therefore, no medical claims are made for the "Naeser Laser Home Treatment Program for the Hand ©." It is up the patient to decide whether he/she wants to try this Home Treatment program under the supervision of a licensed acupuncturist who is trained in the use of laser acupuncture. This information is offered as one possible alternative therapy for the treatment of painful symptoms associated with CTS.

Here are some pictures of this therapy in action!

The Cost of Carpal Tunnel Syndrome

Current Cost Estimates to Treat Carpal Tunnel Syndrome in the U.S.

One firm estimates that it costs a company $37,000 in lost work time, medical treatments and rehabilitation for each worker who develops CTS (Respondex Systems, Dixon, IL, personal communication). Workman's Compensation figures estimate $6,000 to $10,000 per case (depending on whether only one hand is involved, or both hands are involved); an average cost would be $8,000, in a well-managed case (David C. Alexander, Auburn Engineers, Inc., Auburn, AL, in Dimmitt, 1995). Because the incidence of CTS continues to increase (especially in work requiring repetitive hand movements, particularly computer keyboard users), it is important to consider painless, non-invasive, non-surgical treatments, which can be administered by the patient him/herself at home, and are low in cost.

Potential Cost Savings with use of this Treatment Program

The primary advantage of the "Naeser Laser Home Treatment Program," is a much lower cost to treat the painful symptoms of CTS, than current treatments. The current Workman's Compensation figures are around $8,000, for a well-managed case. The cost with this program, which uses a red-beam laser pen and microamps TENS device with home treatment, is around $1,100 per case. The cost of the red-beam laser pen is $142. The cost of the MicroStim 100 TENS device is $895; Insurance usually pay 80% on the purchase of a TENS device. The cost of one visit to an acupuncturist is around $60. Thus, the total cost for this treatment program is around $1,100 per case. The potential cost savings are presented in Table 2. Table 2 suggests that if this treatment program is successful in even half of the current 1.89 million cases of CTS in the U.S. today, there could be a cost savings of greater than $6 billion per year.

Laser Acupuncture Frequently Asked Questions

Table 1. Proposed Definition of Work-Related Carpal Tunnel Syndrome National Institute of Occupational Safety and Health (NIOSH) (Matte et al., 1989)

Criteria A, B, and C must be met:

  • A. Symptoms suggestive of CTS:
    "paresthesia, hypoesthesia, pain or numbness affecting at least part of the median nerve distribution of the hand."
  • B. Objective findings consistent with CTS:
    EITHER
    • One or more of the following physical findings:
      • Tinel's sign
      • Phalen's sign, or
      • "decreased or absent sensation to pin prick in the median nerve distribution of the hand."

    OR
    • "Electrodiagnostic findings of median nerve dysfunction across the carpal tunnel."
    • C. Evidence of work relatedness:
      One or more of the following:
      • Frequent, repetitive or forceful hand work on affected side
      • Sustained awkward hand position
      • Use of vibrating tools
      • Prolonged pressure over wrist or base of palm
      • Temporal relationship of symptoms to work or association with CTS in co-workers

Table 2. Potential Cost Savings with Laser Acupuncture and Microamps TENS Treatments for Carpal Tunnel Syndrome

Current Medical Treatment estimated average cost in the U.S., to treat 1 case of CTS (cost is based on Workman's Comp. Range = $6,000 to $10,000): $ 8,000 Estimated cost to treat 1 case of CTS with Laser Acupuncture and Microamps TENS (includes patient-managed self-care at home):

Cost Item
$ 142 5 mW Laser Pen
$ 895 Microamps TENS Device
$ 60 1 Acupuncture visit to learn how to administer the Treatments at home
Total $ 1,097 (approx. $1,100)

Given that the current cost to treat one case of CTS is $8,000 and the current cost for Laser Acupuncture/TENS is $1,100, the savings per patient is $6,900.

If the number of CTS cases is only half of the estimated 1.89 million cases - i.e., there are at least 945,000 cases of carpal tunnel syndrome, the cost for nationwide treatment of CTS would equal: $7,560,000,000 for the existing treatment plan, or $1,039,500,000 for the Laser/TENS treatment plan.

The potential cost savings for treatment of CTS with Laser Acupuncture and Microamps TENS with this patient-managed home treatment program under supervision of a licensed acupuncturist is $6,520,500,000.

References

  • Basford JR. (1989). Low-energy laser therapy: Controversies and new research findings. Lasers Surg. Med., 9, 1-5.
  • Chen GS. (1990). The effect of acupuncture treatment on carpal tunnel syndrome. American Journal of Acupuncture, 18, 5-9.
  • Cheng N, Van Hoof H, Bockx E, et al. (1982). The effects of electric currents on ATP generation, protein synthesis, and membrane transport in rat skin. Clinical Orthopaedics, 171, 264-272.
  • Dimmitt, BS. (1995). Repetitive stress injuries: Relieving pain at the bottom line. Business & Health (May), 13 (5), 21.
  • Feldman RG, Travers PH, Chirico-Post J, Keyserling WM. (1987). Risk assessment in electronic assembly workers: Carpal tunnel syndrome. J Hand Surg, 12A(2 Pt 2), 849-855.
  • Gelberman RH, Aronson D, Weisman MH. (1980). Carpal tunnel syndrome: Results of a prospective trial of steroid injection and splinting. J. Bone Joint Surg., 62A: 1181.
  • Goodman HV, Foster JB. (1962). Effect of local corticosteroid injection on median nerve conduction in carpal tunnel syndrome. Ann. Phys. Med., 6, 287.
  • Matte TD, Baker EL, Honchar PA. (1989). The selection and definition of targeted work-related conditions for surveillance under SENSOR. Am. J. Public Health, 79 Suppl., 21-25.
  • Mester E, Toth N, Mester A. (1982). The biostimulative effect of laserbeam. Laser Basic Biomed. Res., 22, 4.
  • Naeser MA, Hahn KK, Lieberman B. (1996). Real vs. Sham Laser Acupuncture and Microamps TENS to Treat Carpal Tunnel Syndrome and Worksite Wrist Pain: Pilot Study. Paper for presentation at the 16th Annual Meeting, American Society for Laser Medicine and Surgery, Inc., April 15, 1996, Lake Buena Vista, FL.
  • Naeser MA & Wei XB (1994). Laser Acupuncture - An Introductory Textbook for Treatment of Pain, Paralysis, Spasticity and Other Disorders. Boston, Boston Chinese Medicine.
  • Occupational Disease Surveillance: carpal tunnel syndrome. MMWR, 1989, 38, 485-489.
  • Passarella S. (1988). The effect of Helium-Neon laser irradiation on structure and function of isolated mitochondria in vitro. 1st Omega Low Power Laser Seminar, Guy's Hospital, London, April 1988.
  • Passarella S, Casamassima E, Molinari S, et al. (1984). Increase of proton electrochemical potential and ATP synthesis in rat liver mitochondria irradiated in vitro by Helium-Neon laser. FEBS Lett., 175, 95.
  • Rosenbaum RB, Ochoa JL. (1993). Carpal Tunnel Syndrome and Other Disorders of the Median Nerve. Boston: Butterworth-Heinemann.
  • Seitz LM, Kleinkort JA. (1986). Low-power laser: Its applications in physical therapy. In S.L. Michlovitz and S.L. Wolf (eds.) Thermal Agents in Rehabilitation. Philadelphia: F.A. Davis Company, 217-238.
  • Slater RR Jr., Bynum DK. (1993). Diagnosis and treatment of carpal tunnel syndrome. Orthopaedic Review, Oct. 1993, 1095-1105.
  • Walker J. (1983). Relief from chronic pain by low power laser irradiation. Neurosci. Lett., 43, 339-344.

About Dr. Margaret A. Naeser

Margaret A. Naeser received her B.A. from Smith College, and her Ph.D. degree in Linguistics from the University of Wisconsin (1970). She is a Research Professor of Neurology, Boston University School of Medicine, where she conducts rehabilitation research with stroke and CTS patients. She is a graduate of the New England School of Acupuncture and is a Licensed Acupuncturist in Massachusetts. In 1985, she was invited by the Shanghai Medical University to exchange research information. While in China, she studied the use of acupuncture and laser acupuncture in the treatment of paralysis in stroke patients. She has published four papers on this research, and two books: Outline Guide to Chinese Herbal Patent Medicines in Pill Form - with Sample Pictures of the Boxes, and Laser Acupuncture - An Introductory Textbook for the Treatment of Pain, Paralysis, Spasticity and Other Disorders.

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