Inclusion Criteria:

• Hand or wrist pain combined with parathesias or numbness in any or all fingers, predominating in a median nerve distribution, and especially occurring at night
• Symptoms unresponsive or poorly responsive to standard conservative therapy (wrist splints, analgesics, nonsteroidal anti-inflammatory drugs)
• Electrodiagnostic evidence of distal median neuropathy compatible with carpal tunnel syndrome (to be confirmed at study site)
• Symptoms present for at least 3 months
• No prior treatment with acupuncture for carpal tunnel syndrome

Exclusion Criteria:

• Evidence of pronounced abductor pollicis weakness or significant thenar wasting (probable candidate for carpal tunnel surgery)
• Prior carpal tunnel surgery on affected side
• Use of narcotic analgesia
• History of wrist or hand fracture on the symptomatic limb
• Current pregnancy or less than 3 months postpartum
• Corticosteroid injection into the carpal tunnel within 3 months
• History of generalized peripheral neuropathy or clinical or electrodiagnostic evidence of generalized polyneuropathy or mononeuropathy multiplex
• History of other neurologic disorders which may cause confusion with the diagnosis of carpal tunnel syndrome, including but not limited to stroke, cervical radiculopathy, myelopathy, subdural hematoma, brain tumor
• Inflammatory articular disease or tendinitis of the hand or wrist by history or physical examination
• Insulin-dependent diabetes mellitus
• Clinical hypothyroidism
• Chronic renal failure or renal dialysis or forearm fistulae
• Other disorder known to predispose to carpal tunnel syndrome including acromegaly, multiple myeloma, amyloidosis