Acupuncture to relieve

unilateral numbness and tingling

in the upper extremities:
A case report

KEYWORDS: acupuncture, tingling, numbness, increase, blood flow.

Student/Author: Sophia Mitsiki-Murray

Student Number: 234705

Clinic Supervisors: Mark Shoring, Patricia Reynolds, Charity Carleton

Allocated Supervisor: Mark Shoring

Clinic Session: Friday 11:30 am – 14:30 pm

Subject Code: CMCS421 Chinese Medicine –
Acupuncture Clinical Studies 7

Semester: Semester 1 2015

Due Date: Sunday 24 May 2015

Word Limit: 500 words +/- 10% (450-550)

Word Count: 514 words
Sophia Mitsiki-Murray - 234705

ABSTRACT

A possible explanation for numbness/tingling in the fingers, common among computer users,
is nerve compression and subclinical carpal tunnel syndrome (Overgaard et al. 2004, p.521).
According to the literature review acupuncture can increase blood flow through activation of
thin nerve fibres (Hsiao & Tsai 2008, p.46), dermatomes and acupuncture points have
functional associations via viscerocutaneous reflexes and (Molano et al. 2014, pp.10-11)
and dermatomes partly determine the therapeutic efficacy of acupuncture (Ferreira & Luiz
2013, p.11). Furthermore, needling specific points such as LR3 can increase circulation in
the upper limbs (Takayama et al. 2012, pp.4,7) and potent analgesic effect on the
extremities can be induced with electroacupuncture (Leung et al. 2008, p.11). This case
study illustrates that acupuncture except an analgesic effect can also reduce numbness and
tingling on the upper extremities. Future high quality research could focus on the specific
mechanism behind numbness and tingling and how acupuncture alleviates these symptoms.
122

INTRODUCTION / CASE HISTORY DESCRIPTION

A 61-year-old female office worker from Denmark, presented with pain on the wrist and
continuous numbness and tingling initiating from the shoulder till the tips of the fingers on the
right arm. Condition was 6 days old, the pain and numbness caused frequent waking at night
and symptoms were aggravated by computer use or wrist overuse. Patient hadn’t visited the
doctor and stated she was not willing to do so. Carpal tunnel tests (Phalen’s and Tinel) gave
negative results. Palpation revealed extremely tight shoulders and initial diagnosis
suggested possible nerve compression on the C7 level and dermatome affecting middle and
ring fingers. Treatment plan: acupuncture twice/week for 3 weeks (end of semester).
Expected outcome: relieve pain, numbness and tingling to obtain uninterrupted sleep. Actual
outcome: pain totally alleviated, numbness and tingling close to totally alleviated, sleep was
uninterrupted.
Recommendations: tui na massage, neck stretches during office hours, light exercise.149

Table of Presentation & Treatment

Signs Diagnosis Treatment
Session & & Formula
Symptoms Treatment principle
Examinations:

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Questioning, listening, observation

& palpation:
 Continuous tingling and
numbness from shoulder to
fingers on right hand
 Continuous pain/soreness GB20 Fengchi
that wakes her up at night GB21 Jianjing
 Feels a lot of tension and GB40 Qiuxu
tightness on the neck due D: LI4 Hegu
to computer work at office Blood xu due to qi TE4Yangchi

 Symptoms are worse for stagnation along the Du MBW35 Huatuojiaji

1 driving, typing on the + GB channels of the at C7 level

computer for a long time, neck affecting mainly the GB34

using the wrist a lot, RHS arm, wrist and Yanglingquan

 Blood pressure t times rises fingers

but no medication, TP: Strong stimulation

 Not willing to visit doctors Move Qi along the Du & during needling

for BP or this condition GB channels of the neck,

 Three soft lumps without relieve pain and

defined edges around wrist numbness, build blood Feedback: pain,

area, that reduce in size numbness and

after rubbing or pressure tingling were

Tongue: slightly pale with purple in alleviated straight

the middle, flabby with distinct ST after treatment

crack, thin white moss.

Pulse: 62beats/min, regular,
slippery, weak and KI wiry.
2  Did not wake up during
sleep for 4 days after
treatment, the rest of the
days was able to go back to
sleep after waking
 Pain/soreness was reduced
a lot
 Numbness and tingling very Repeat previous
light, moved to the 3rd and treatment additional
4th finger and slight on the Same as previous week point:
wrist only HT7 Shenmen

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 Daughter had operation and

week was quite emotional
causing some anxiety and
HT palpitations
 First treatment had the
most potent effect
Tongue: middle crack till the tip of
the tongue, pale some serrations,
flabby, thin white moss.
Pulse: 68beats/min, regular,
slippery, a little thin.
 Very light tingling only on
the middle and ring fingers,
nearly hard to notice,
worsens with excessive
computer work at times
 No pain/soreness,
 Not waking at night any MBW35 Huatuojiaji
3 more and has a very restful at C7 level
sleep GB20 Fengchi

 Able to lift full kettle, this D: Qi Stagnation causing GB34

was quite painful prior to blood xu on right 3rd and Yanglingquan

treatment 4th finger, underlying Sp LI4 Hegu

 Very happy with progress, qi xu with damp heat TE4 Yangchi

which feels life-hanging T: move qi tonify Sp qi HT7 Shenmen

 Stress and energy are both and resolve damp heat PC6 Neiguan

7/10 LR3 Taichong

 Week very stressful with SP9 Yinlingquan

serious health issues in two

members of immediate
family
 Explosive stools this week
with odour, 2-3 times per
day, and 2-3 hours after
meals
Tongue: middle crack till the tip of
the tongue, pale overall with slight

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purple hue in middle, thin white

moss
Pulse: 70beats/min, slippery with
middle jiao full on both sides

LITERATURE REVIEW

Table of Literature Review Search

Database Keywords Limitations Results

Cochrane Library Acupuncture, numbness and - 1
tingling
Cochrane Library Acupuncture, blood flow - 2
Ebsco Host Acupuncture, numbness  full text 58
Ebsco Host Acupuncture, numbness, - 7
tingling
Ebsco Host Acupuncture, blood flow  full text 152
 scholarly peer
reviewed
 2000 to 2015
Ebsco Host Acupuncture, increase, same as above 65
blood flow
Pub Med Acupuncture, numbness - 67
Pub Med Acupuncture, blood flow  free full text 96
Pub Med Acupuncture, blood flow,  free full text 35
increase

Literature review findings:

 acupuncture increases blood flow as it activates thin nerve fibres, which release
vasoactive neuropeptides and Nitric Oxide causing vasodilation and increased blood
flow (Hsiao & Tsai 2008, p.46)
 clear anatomical and functional associations between dermatomes and acupuncture
channels and points due to common viscerocutaneous reflexes (Molano et al. 2014,
pp.10-11)

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 dermatomes partly determine the therapeutic efficacy of acupuncture (Ferreira & Luiz
2013, p.11)
 acupuncture can increase blood flow in peripheral circulation and needling LR3 can
affect the circulation in the upper limbs (Takayama et al. 2012, pp.4,7)
 Possibly 15-min electroacupuncture stimulation provides optimal analgesic results as
tested for the lower extremities (Leung et al. 2008, p.11). 84

DISCUSSION / CASE PRESENTATION / TREATMENT OUTCOME

Despite recommendations as per duty of care patient did not want to visit western medical
practitioners for her numbness/tingling or her fluctuating blood pressure, her wishes were
respected. During the first session of needling when points on the same channel were
needled patient felt them connecting strongly with each other and she was very responsive
to acupuncture. The course of illness was only a week long prior to treatment therefore the
course of treatment was not expected to be too long. There were no adverse reactions in
this case, strong needle stimulation was used and working with dermatomes from first
treatment appeared very successful Since semester ended on third week of treatment client
was provided with details of two different acupuncturists to chose from and visit close to her
home. This case was very inspiring and proved the big difference correct diagnosis makes.
143

CONCLUSIONS / SUMMARY

Acupuncture can have an analgesic effect and significantly reduce numbness and tingling in
the upper extremities. 16

REFERENCES

1. Ferreira, AS & Luiz, AB 2013, ‘Role of dermatomes in the determination of therapeutic

characteristics of channel acupoints: a similarity based analysis of data compiled from
literature’, Chinese medicine, vol. 8, no. 24, pp.1-12, viewed 19 May 2015,
<http://ncbi.nlm.nih.com>.

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2. Hsiao, SH & Tsai, LJ 2008, ‘A neurovascular transmission model for acupuncture-induced

Nitric Oxide’, Acupuncture meridian studies, vol. 1, no.1, pp. 42-50, viewed 20 May 2015,
<http://ncbi.nlm.nih.com>.

3. Leung, AY, Kim, SJ, Schulteis, G & Yaksh, T 2008, ‘The effect of acupuncture duration on
analgesia and peripheral sensory thresholds’, BMC complementary and alternative
medicine, vol. 8, pp. 1-11, viewed 20 May 2015, <http://ncbi.nlm.nih.com>.

4. Molano, BML, Bonilla, PLB, Dussan, BEH & Londono, VCA 2014, ‘Anatomo-functional
correlation between head zones and acupuncture channels and points: a comparative
analysis from the perspective of neural therapy’, Evidence-based complementary and
alternative medicine, no. 836392, viewed 19 May 2014, <http://www.ncbi.nlm.nih.gov>.

5. Overgaard, E, Brandt, LPA, Ellemann, K, Mikkelsen, S & Andersen, JH 2004,

‘Tingling/numbness in the hands of computer users: neurophysiological findings from the
NUDATA study’, vol. 77, no.7, pp. 521-525, International Archives of occupational and
environmental health, viewed 19 May 2015, <http://www.ebscohost.com>.

6. Takayama, S, Watanabe, M, Kusuyama, H, Nagase, S, Seki, T, Nakazawa, T &

Yaegashi, N 2012, ‘Evaluation of the effects of acupuncture on blood flow in humans with
ultrasound color doppler imaging’, Evidence-based complementary and alternative medicine,
vol. 2012, no. 513638, pp. 1-8, viewed 20 May 2015, <http://www.ebscohost.com>.