Vitamin D for symptoms of carpal tunnel syndrome

Recent research published in the journal Nutrients Explore the role of vitamin D in the management of carpal tunnel syndrome (CTS).

study: The role of vitamin D in the treatment of carpal tunnel syndrome: clinical and electroneuromuscular responsesImage credit: Alliance Images / Shutterstock.com

What is CTS?

CTS is one of the most common peripheral neuropathy affecting the anatomy of the wrist. CTS causes compression of the median nerve, a large nerve that innervates the arm, forearm, and hand. This compression causes patients to experience pain, numbness, or tingling along the area of ​​the upper extremity affected by the pressure. Additionally, CTS often leads to weakened grip strength and hand function.

Obesity, diabetes, repetitive stress injuries, rheumatic inflammation, pregnancy, and genetic factors interact to increase the risk of CTS. CTS usually affects people between the ages of 40 and 60, but can affect people of other ages. Women are twice as likely as men to suffer from CTS, with 193 women and 88 men affected per million.

Vitamin D and CTS

Vitamin D is a fat-soluble vitamin that regulates calcium and phosphorus metabolism and immune function. It is also important for endocrine, cardiovascular, skeletal and skin health and is associated with metabolic and antioxidant/anti-inflammatory properties.

Therefore, vitamin D deficiency may potentiate several neuropathic or pain syndromes associated with increased inflammation. Vitamin D deficiency also increases the severity of CTS symptoms.

For now, it is unclear how vitamin D supplementation may help manage CTS.

About the Research

The study involved 14 CTS patients from two centers. All study participants had CTS in one or both wrists and low vitamin D levels. They had not taken vitamins in the six months prior to the study period and had no history of medical or surgical treatment for CTS.

Study participants were also screened for other conditions that may cause CTS or similar symptoms, such as neuropathy, inflammatory syndromes, trauma to the affected limb, poorly controlled diabetes, thyroid and parathyroid diseases, neck problems, obesity, etc. All study participants were women, with an average age of 51 years.

Participants were randomized to receive corticosteroid therapy alone or corticosteroids plus vitamin D supplements. Block randomization was employed to ensure homogeneity within the cohort.

Graphical Abstraction

What did the study find?

In CTS patients with low vitamin D levels, adding vitamin D to corticosteroid therapy has been shown to reduce pain, decrease symptom severity, and improve certain electromyographic (EMG) parameters.

At baseline, Phalen and Tinel tests were performed in all patients, with positive rates of 86% and 71%, respectively. When stratified by group, the intervention group had a Phalen positivity rate of 100% at baseline, which decreased to 75% after 3 months. In comparison, the corticosteroid treatment-only group had Phalen positivity rates of 67% and 33%, respectively.

At baseline, patients receiving corticosteroids alone had a positive Tinel test of 50%, which decreased to 33% after 3 months. Vitamin D supplementation resulted in a positive Tinel test of 75% after 3 months, compared with 88% at baseline.

The intervention group experienced greater reduction in pain than the control group, which is consistent with increased vitamin D levels. Symptom severity was reduced in both groups, but no significant improvement in functional status was observed.

EMG showed that median nerve motor latency and perceived driving speed improved in the intervention group.

Conclusion

Previous studies have shown that vitamin D deficiency increases the risk of CTS and the severity of symptoms. This study supports these findings and suggests that vitamin D supplementation in CTS patients with low vitamin D levels may reduce levels of innervation and hypersensitivity, thereby reducing pain sensations and nerve tingling. Low vitamin D levels increase the severity of symptoms, but after three months of supplementation in conjunction with corticosteroid therapy, symptoms improved.

Vitamin D prevents neurological disorders such as CTS by suppressing the expression of L-type calcium channels and upregulating vitamin D receptors and their antioxidant activity.

Vitamin D supplementation improves pain severity in CTS. Furthermore, vitamin D has an effect on reducing the severity of symptoms in CTS patients, but does not affect their functional status.. “

Although the Tinel and Phalen tests are often used for diagnosis rather than for monitoring treatment, clinical improvement was seen in both groups, thus demonstrating that these tests also have a role for monitoring.

Future studies with larger sample sizes, longer follow-up periods, and other evaluation tools are suggested to validate and extend the findings of this experiment.