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Carpal Tunnel Syndrome

How Chinese medicine differentiates carpal tunnel syndrome, the six patterns you'll actually meet in practice, and the points for each. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Progressive muscle wasting at the base of the thumb, or numbness that doesn't improve, needs medical evaluation. None of this site's 11 pattern decks contain a "Painful Obstruction" (Bi Syndrome) category for musculoskeletal channel pain — they are organized around internal-medicine organ patterns instead — so none of the 6 patterns below link to a deck slide; every point below still links to its own points-deck entry.
General Acupuncture Points

Acupuncture points traditionally used for carpal tunnel syndrome — 12 key points, used across most of the patterns below rather than tied to just one.

PointKey action
P-7Calms the Mind, clears Heat and Toxic-Heat, harmonizes the Stomach.
P-6Opens the chest, moves Qi and Blood, calms the Mind.
L.I.-4Expels exterior Wind, stops pain, removes obstructions from the channel.
T.B.-5Expels Wind-Heat, benefits the ears, clears Heat in the head.
T.B.-4Removes obstructions from the channel, promotes fluid transformation, benefits Original Qi.
ST-40Resolves Phlegm and Dampness, opens the chest, subdues rebellious Qi.
SP-9Regulates the Spleen, resolves Dampness, opens the Water passages.
L.I.-11Clears Heat, regulates the Intestines, removes obstructions from the channel.
ST-36Benefits Stomach and Spleen, tonifies Qi and Blood.
SP-6Strengthens the Spleen, resolves Dampness, nourishes Blood and Yin.
KI-3Tonifies the Kidneys (Yin and Yang), strengthens Essence.
LIV-3Subdues Liver-Yang, promotes the smooth flow of Liver-Qi, invigorates Blood.
The Six Patterns

reinforcing   reducing   even method — technique below follows standard Excess/Deficiency treatment principle for each pattern, not tied to a specific point-by-point source.

1. Qi and Blood Stagnation

Clinical manifestations: Stabbing, fixed pain in the wrist and hand; pain worse with pressure or repetitive use; tingling and numbness in the thumb, index and middle fingers; brought on by repetitive strain, an old injury, prolonged awkward wrist posture, or overuse; eased by gentle movement, warmth, rest from repetitive tasks, or gentle massage once the acute pain settles.
Tongue: Dark purple body with stasis spots, distended sublingual veins. Pulse: Wiry, Choppy.
Treatment principle: Move Blood, clear stasis, relieve pain, especially fixed stabbing pain in the limbs.
Note: no moxa.

2. Painful Obstruction with Wind-Cold-Damp

Clinical manifestations: Wrist pain and numbness that is worse in cold, damp weather; a cold sensation in the wrist and fingers; heaviness and stiffness, especially in the morning; symptoms relieved by warmth and gentle movement; brought on by cold and damp exposure, repetitive strain in cold conditions, or sudden weather changes; eased by warmth, a warm compress, gentle stretching, or moxibustion.
Tongue: Pale, slightly swollen body with tooth marks, white greasy coating. Pulse: Wiry and Tight, or Slow.
Treatment principle: Dispel Wind-Cold-Damp from the channels, relieve pain and stiffness.
Note: moxa applicable.

3. Phlegm in the Channels, Joints and Muscles

Clinical manifestations: A heavy, swollen sensation in the wrist and hand; fixed, stabbing pain that feels deep and hard; purplish or dark discoloration around the wrist; stubborn numbness or a clumsy, dulled feeling; brought on by a diet heavy in greasy or sweet food, damp weather, a sedentary lifestyle, or chronic Spleen weakness feeding Phlegm production; eased by warm, plainly-cooked food, staying active, or a dry warm environment.
Tongue: Purple body with stasis spots, white greasy coating, distended sublingual veins. Pulse: Wiry and Choppy, or Wiry and Slippery if Phlegm predominates.
Treatment principle: Clear Phlegm, unblock the channels.
Note: no moxa.

4. Painful Obstruction Due to Damp-Heat in Channels

Clinical manifestations: A red, swollen wrist that feels hot to the touch; burning pain in the wrist and hand; pain relieved by cold, worsened by warmth; a heavy, aching sensation in the forearm; thirst; a feeling of bodily heat; pain worse at night; brought on by hot humid weather, spicy or greasy food, alcohol, or an acute flare of a chronic injury; eased by cool compresses, cooling food and drinks, rest, or avoiding heat on the area.
Tongue: Red body, possibly slightly swollen, yellow greasy coating. Pulse: Slippery, Rapid.
Treatment principle: Clear Heat, dry Dampness, reduce local swelling, redness and burning pain.
Note: no moxa.

5. Qi and Blood Deficiency

Clinical manifestations: Fatigue and general weakness; a pale complexion and lips; wrist numbness and tingling worse with exertion; dizziness or lightheadedness; poor appetite; heart palpitations; a weak grip and easily fatigued hands; brought on by overwork, chronic illness, poor diet, or a long recovery from injury; eased by rest, warm nourishing food, gentle graded exercise, or moxibustion.
Tongue: Pale body, may be thin or have tooth marks, thin white coating. Pulse: Fine (thin), Weak, especially at the right Guan position.
Treatment principle: Tonify Qi and Blood to nourish the channels and sinews.
Tonify Qi-Blood
Local channel
Note: moxa applicable on the tonifying points.

6. Kidney and Liver Yin Deficiency

Clinical manifestations: Wrist numbness with a warm or burning quality; symptoms worse at night or with fatigue; a weak grip and easily fatigued hands; soreness and weakness in the lower back and knees; dizziness, tinnitus, or ringing in the ears; dry eyes, blurred vision, or floaters; night sweats and heat in the palms, soles and chest; restless sleep with vivid dreams; brought on by ageing, chronic overwork, excessive sexual activity, or lack of sleep; eased by rest, avoiding stimulants in the evening, or a calm quiet environment before bed.
Tongue: Red, thin body with cracks, little or no coating, dry surface. Pulse: Fine, Rapid, Wiry, weak at the left Chi (Kidney) position.
Treatment principle: Nourish Kidney and Liver Yin, restore the moisture that lubricates the channels and tendons.
Tonify Kidney-Liver Yin
Local channel
Note: no moxa (Yin deficiency).
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