Local Effects of Acupuncture and Nerve Conduction Studies

Exclusion Criteria

• •Conditions in which acupuncture/electroacupuncture may be contraindicated:
• •Coagulopathy/ Current anti-coagulation treatment
• •Epilepsy
• •History of CAD or pacemaker insertion
• •Pregnancy
• •Presence of any skin condition in the arm, such as dermatitis, bruises, weeping skin, skin lesions, infected skin, or necrotic skin.
• •Conditions in which QST testing may be contraindicated:
• •Significant cognitive impairment such as diagnosis of Alzheimer's disease or Mental Retardation or any other condition interfering with alertness, attention and ability to participate in QST
• •Hospitalization for anxiety or depression in the past 3 months
• •Current psychiatric diagnoses (other than anxiety or depression)
• •Illicit drug use in the past month
• •Current EtOH abuse (\> 2 drinks/day)
• •History of significant neurological disease which may affect sensation, e.g., strokes, Multiple Sclerosis, or spinal cord disorder
• •Change in neuropathy medications within the past 2 months
• •Change in opioid, benzodiazepines, SSRIs or other sedating medications in the past 2 months
• •Conditions, which predispose to generalized neuropathy
• •Abnormal thyroid function tests (by history)
• •Past chemotherapy treatment
• •Other Contraindications:
• •History of wrist or elbow fracture, past arm trauma, loss of fingers, scarring
• •History of carpal tunnel release surgery or any other surgery on the arm or shoulder
• •History of arthritis
• •Use of any investigational drugs within the previous six months
• •Presence of isolated motor Median neuropathy (absence of sensory neuropathy on NCS or absence of sensory symptoms)
• •Severe neuropathy symptoms leading to inability to tolerate acupuncture or QST
• •Presence of Severe Carpal Tunnel Syndrome, defined as:
• •1. Absent sensory nerve action potential recorded from the second or fifth digit.
• •2. The amplitude of the compound muscle action potential recorded from the APB or ADM is less than 50% of normal (\< 2.5 mv)
• •Presence of Ulnar neuropathy
• •Presence of Martin-Gruber anastomosis
• •Failure to comply with QST due to inattentiveness, etc
• •Hyperalgesia on QST
• •Hypoalgesia on QST
• •Inability to confirm diagnosis of mild-moderate CTS (normal NCS)
• •Inability to tolerate NCS/QST
• •Presence Severe CTS
• •Pure Motor Median Neuropathy
• •Ulnar Neuropathy