Effectiveness and safety of acupuncture for carpal tunnel syndrome: An overview of systematic reviews and meta-analyses

Several systematic reviews (SRs) and meta-analyses (MAs) have explored the effectiveness and safety of acupuncture for Carpal Tunnel Syndrome (CTS), but findings are inconsistent and vary in quality. Therefore, this overview aims to evaluate these SRs and MAs critically, synthesizing existing evidence on acupuncture in treating CTS. We searched 7 databases from their inception to April 25, 2024, using the keywords “acupuncture”, “carpal tunnel syndrome”, and “systematic review”. Methodology and reporting quality were assessed using AMSTAR 2 and PRISMA. The risk of bias was evaluated using ROBIS, and evidence certainty was appraised using GRADE. 9 related SRs/MAs were included, with 8 judged as critically low quality and 1 rated as low quality by AMSTAR 2. According to the PRISMA checklist, while 7 SR/MAs were found to adequately report over 70 %, none reported all items. The ROBIS assessment rated 4 SRs/MAs with a low risk of bias and 5 with a high risk. The quality of evidence evaluated by GRADE was low or very low. Descriptive analyses indicated that acupuncture could effectively reduce pain intensity, but evidence on responder rate, symptom severity, functional status, and electrophysiological parameters was inconsistent. No serious adverse events associated with acupuncture were found. Acupuncture might be beneficial for CTS. However, given the existing evidence limitations, the efficacy of acupuncture for CTS requires confirmation through further high-quality research. PROSPERO (CRD42023409659).