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While patients with carpal tunnel syndrome (CTS) report pain and paresthesia in conjunction with decreased median nerve conduction velocities, patients with idiopathic hand pain (IHP) report similar symptoms but with normal nerve conduction. While brain plasticity has been reported for CTS, the effects of acupuncture on structural plasticity in either IHP or CTS are unknown. We evaluated 19 IHP patients, 21 CTS patients, and 13 healthy controls (HC) with structural T1-weighted MRI at 3T (Siemens Trio) before and after 8weeks of acupuncture. Symptoms were evaluated with the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) before, after, and 3-months following acupuncture therapy. Acupuncture included 2Hz electrical stimulation at acupoints PC7 and TW5 near the affected wrist. Gray matter thickness data were contrast between IHP and CTS at baseline, and before versus after acupuncture …