by Dr. Leo Galland

 

An Oil Change for Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the main nerve to the hand (the median nerve), is damaged as it passes over the inside of the wrist, travelling through a path of fibers called the carpal tunnel. Symptoms of carpal tunnel syndrome include pain, tingling, numbness and weakness of either hand, involving the thumb, forefinger and middle finger.

 

It’s a significant problem for people who spend a lot of time using computers, because typing on a keyboard or operating a mouse can cause tightness in the carpal tunnel. A research team in Italy tested a combination of two nutrients, alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA), for treatment of carpal tunnel syndrome, comparing the ALA/GLA combination with a high dose B-vitamin supplement. They found that the ALA/GLA supplement improved symptoms of carpal tunnel and the function of the median nerve, whereas the B-vitamin had no significant effects. Please see research abstract below to learn more.

 

ALA is a powerful antioxidant that has been studied for its ability to help other types of nerve damage. GLA is an omega-6 fatty acid with anti-inflammatory effects. GLA is found in evening primrose oil, borage seed oil and black currant seed oil.

 

Another Italian research group has tested an ALA/GLA combination in patients with back pain caused by pressure on nerve roots (a condition called radiculopathy) and found beneficial effects on pain control.

 

References and Abstracts:

 

Eur Rev Med Pharmacol Sci. 2009 Mar-Apr;13(2):133-9. Treatment of carpal tunnel syndrome with alpha-lipoic acid. Di Geronimo G, Caccese AF, Caruso L, Soldati A, Passaretti U. UO Chirurgia della Mano e dei Nervi Periferici, Presidio Ospedaliero dei Pellegrini, Napoli, Italy. a.digeronimo@alice.it

 

Carpal Tunnel Syndrome (CTS) is the most common peripheral mononeuropathy; its symptoms and functional limitations significantly penalize the daily activities and quality of life of many people. While surgery is reserved to most severe cases, the earlier stages of disease may be controlled by a pharmacological treatment aimed to "neuroprotection", i.e. to limiting and correcting the nerve damage. Our study was aimed to compare the efficacy of a fixed association of alpha-lipoic acid (ALA) 600 mg/die and gamma-linolenic acid (GLA) 360 mg/die, and a multivitamin B preparation (Vit B6 150 mg, Vit B1 100 mg, Vit B12 500 microg daily) for 90 days in 112 subjects with moderately severe CTS. Demographic, case-history and treatment efficacy data were collected; the Boston questionnaire was administered and the patients were evaluated by Hi-Ob scale and electro-myography. A significant reduction in both symptoms scores and functional impairment (Boston questionnaire) was observed in ALA/GLA group, while the multivitamin group experienced a slight improvement of symptoms and a deterioration of functional scores. Electromyography showed a statistically significant improvement with ALA/GLA, but not with the multivitamin product. The Hi-Ob scale showed significant efficacy of ALA/GLA in improving symptoms and functional impairment, while in the multivitamin group the improvement was significant, but less marked than in the ALA/GLA group. In conclusion, the fixed association of ALA and GLA proved to be a useful tool and may be proposed for controlling symptoms and improving the evolution of CTS, especially in the earlier stages of disease.

 

Int J Immunopathol Pharmacol. 2009 Jul-Sep;22(3 Suppl):45-50. The use of alpha-lipoic acid (ALA), gamma linolenic acid (GLA) and rehabilitation in the treatment of back pain: effect on health-related quality of life. Ranieri M, Sciuscio M, Cortese AM, Santamato A, Di Teo L, Ianieri G, Bellomo RG, Stasi M, Megna M. Physical Medicine and Rehabilitation Unit, Neurological and Psychiatric Sciences Department, Aldo Moro University, Bari 70124, Italy. ranieri@neurol.uniba.it

 

The aim of this trial was to evaluate the effects of alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA) and the beneficial effect of physical exercise on positive sensory symptoms and neuropathic pain in patients with compressive radiculopathy syndrome from disc-nerve root conflict. Often these painful syndromes after the acute event, tend to recurr becoming subacute or chronic syndromes that become for the period of interest disabiling is an event very important in these cases proper prevention, based on a maintenance drug therapy and the strengthening exercises of paravertebral muscles, flexibility exercises on the spine and when needed on the reduction of body weight. In this Observational Cohort, two-arm trial, 203 patients were enrolled and divided into two groups, the first, ALA and GLA group, (n = 101) received oral dose of 600 mg of alpha-lipoic acid (ALA) and 360 mg of gamma-linolenic acid (GLA) and a rehabilitation program for six weeks, the second (n = 102) treated with only rehabilitation program. Patients were recruited at the centre of Physical Medicine and Rehabilitation, they underwent a physiatric examination at the primary outcome (t0) and secondary outcomes were recorded at monitoring visits scheduled at two weeks = t1, four weeks = t2, six weeks = t3, and at the same has been administered the following scale: VAS scale, SF-36, Oswestry Low Back Pain Disability Questionnaire, Aberdeen Back Pain Scale (ABPS), Revised Leeds Disability Questionnaire (LDQ), Roland and Morris Disability Questionnaire. Significant improvements was noted in the ALA and GLA group for paresthesia, stabbing and burning pain, as showed by VAS (Visual Analogue Scale), Oswestry Low Back Pain Disability Questionnaire, Aberdeen Low Back Pain Scale; also, improvements of quality of life has been noted, in the same group, as showed by SF-36, LDQ (Revised Leeds Disability Questionnaire), Roland and Morris disability questionnaire. All these outcome measure showed statistically significant decreases. Oral treatment with alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA) for six weeks in synergy with rehabilitation therapy improved neuropathic symptoms and deficits in patients with radicular neuropathy.

 

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