Clinical Usefulness of Curcumin Phytosome and B-Group Vitamins for Carpal Tunnel

  1. Clinical Usefulness of Curcumin Phytosome and B-Group Vitamins for Carpal Tunnel

    Clinical Usefulness of Oral Supplementation with Alpha-Lipoic Acid, Curcumin Phytosome, and B-Group Vitamins in Patients with Carpal Tunnel Syndrome Undergoing Surgical Treatment

    Authors: Giorgio Pajardi, Paola Bortot, Veronica Ponti, and Chiara Novelli

    The primary symptoms of classic CTS involve numbness and tingling with or without pain in at least two of the median nerve innervated fingers.

    Common conditions related to secondary CTS include high energy wrist traumas, endocrine disorders (e.g., diabetes mellitus and hypothyroidism), pregnancy, rheumatoid arthritis, anomalous carpal tunnel structures, and occupational factors such as repetitive motion or exposure to vibrating tools . Patients with CTS may experience quite variable sensory symptoms and pain. Paresthesia and pain may extend proximal to the wrist in nearly 40% of cases, whereas predominant involvement of the dorsum of the hand has been reported to occur in 11% of the cases.

    The primary aim of this study was to compare the magnitude of symptoms reduction (hyperalgesia, paresthesia, nocturnal symptoms, and limitations to everyday life) in CTS patients who received
    oral supplementation both before and after surgery compared with those who did not.

    The oral supplement tested in this study was in tablet form and contained alpha-lipoic
    acid (300 mg), curcumin phytosome (500 mg), and B-group vitamins (vitamin B1, 1.05 mg; vitamin B2, 1.2 mg; vitamin B5, 4.5 mg; vitamin B6, 1.5 mg).

    The overall satisfaction with oral supplementation was rated as excellent in 61 subjects (33.9%), good in 84 subjects (46.7%), average in 34 subjects (18.9%), and poor in 1 subject (0.5%). The supplement was well tolerated with no apparent adverse events.

    The results from the present study indicate that CTS patients who received oral supplementation with alpha-lipoic acid, curcumin phytosome, and B-group vitamins twice a day both before and after scheduled surgery, for 3 months each (totaling 6 months of supplementation), had a reduced burden of nocturnal symptoms (as assessed at 40 days postsurgery) and were less likely to have positive Phalen’s test at 3
    months after surgery. The treatment was associated with high satisfaction levels and good compliance.

    Curcumin, a major active polyphenolic compound of turmeric (Curcuma longa), has been reported to have significant neuroprotective effects. Curcumin not only acts as an effective antinociceptive agent [26] but also shows significant anti-inflammatory properties which include its inhibitory effects on the production of several inflammatory mediators. The neuroprotective effects of curcumin have also been explained by possible protection effects against oxidative stress and the induction of antioxidative enzymes.

    In a Cochrane review, Ang and coworkers have critically analyzed the available evidence concerning the potential usefulness of B-group vitamins for treating peripheral neuropathies. The literature review concluded that there is moderate evidence that B-group vitamins at high doses may determine a significant
    short-term reduction in pain, numbness, and paresthesia in these clinical entities.

    We, thus, believe that the lack of adequate supplementation of CTS patients after surgery may
    lead to poor control of symptoms, lost productivity, reduced quality of life, and an increased incidence of complications.

    We also hypothesize that prolonged supplementation may improve symptoms by increasing blood supply to the nerve.

    Phalen’s wrist flexion test is the most commonly reported provocative test for CTS and is generally the most widely accepted.

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