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Andrade AVD, Martins DGS, Rocha GS, Damasceno GS, Gomes FTS, Albuquerque YPF, Melo PKM, Freire MAM, Araújo DP, Oliveira LC, Guzen FP, Morais PLAG, Cavalcanti JRLP. The Role of Vitamin D in the Treatment of Carpal Tunnel Syndrome: Clinical and Electroneuromyographic Responses. Nutrients 2024; 16:1947. [PMID: 38931299 PMCID: PMC11207057 DOI: 10.3390/nu16121947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Carpal tunnel syndrome (CTS) is the most common cause of peripheral compressive neuropathy and consists of compression of the median nerve in the wrist. Although there are several etiologies, idiopathic is the most prevalent origin, and among the forms of treatment for CTS, conservative is the most indicated. However, despite the high prevalence in and impact of this syndrome on the healthcare system, there are still controversies regarding the best therapeutic approach for patients. Therefore, noting that some studies point to vitamin D deficiency as an independent risk factor, which increases the symptoms of the syndrome, this study evaluated the role of vitamin D supplementation and its influence on pain control, physical examination and response electroneuromyography to conservative treatment of carpal tunnel syndrome. For this, the sample consisted of 14 patients diagnosed with CTS and hypovitaminosis D, who were allocated into two groups. The control group received corticosteroid treatment, while the experimental group received corticosteroid treatment associated with vitamin D. Thus, from this study, it can be concluded that patients who received vitamin D, when compared to those who did not receive it, showed improvement in the degree of pain intensity, a reduction in symptom severity and an improvement in some electroneuromyographic parameters.
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Affiliation(s)
- Antônio Vicente D. Andrade
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - Dallianny G. S. Martins
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - Gabriel S. Rocha
- Behavioural and Evolutionary Neurobiology Laboratory, Federal University of Sergipe, Itabaiana, SE 49500-000, Brazil; (G.S.R.); (M.A.M.F.)
| | - Gustavo S. Damasceno
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - Francisca T. S. Gomes
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - Yasmin P. F. Albuquerque
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - Paloma K. M. Melo
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - Marco A. M. Freire
- Behavioural and Evolutionary Neurobiology Laboratory, Federal University of Sergipe, Itabaiana, SE 49500-000, Brazil; (G.S.R.); (M.A.M.F.)
| | - Dayane P. Araújo
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - Lucidio C. Oliveira
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - Fausto P. Guzen
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - Paulo L. A. G. Morais
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
| | - José R. L. P. Cavalcanti
- Laboratory of Experimental Neurology, Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, RN 59607-360, Brazil; (A.V.D.A.); (D.G.S.M.); (G.S.D.); (F.T.S.G.); (Y.P.F.A.); (P.K.M.M.); (D.P.A.); (L.C.O.); (F.P.G.); (P.L.A.G.M.)
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Çupi B, Šarac I, Jovanović JJ, Jovanović S, Petrović-Oggiano G, Debeljak-Martačić J, Jovanović J. Occupational and non-occupational risk factors correlating with the severity of clinical manifestations of carpal tunnel syndrome and related work disability among workers who work with a computer. Arh Hig Rada Toksikol 2023; 74:252-272. [PMID: 38146761 PMCID: PMC10750320 DOI: 10.2478/aiht-2023-74-3754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/01/2023] [Accepted: 12/01/2023] [Indexed: 12/27/2023] Open
Abstract
The contribution of certain occupational and personal factors to the development of carpal tunnel syndrome (CTS) is still uncertain. We investigated which specific occupational and non-occupational factors correlate with the level of clinical manifestations and work disability related to CTS. The study included 190 workers who work with a computer and have diagnosed CTS (100 men, 90 women, aged 20-65 years). Subjective experience of CTS-related impairments was assessed with the Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) of the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). The objective, neural impairments were tested with electrodiagnostics (EDX), whereas CTS-related work disability data were collected from medical records. We found a high inter-correlation between BCTQ, EDX, and work disability data. These also showed high correlations with certain occupational factors (duration of computer-working in months and hours spent daily in computer-working, certain ergonomic, microclimatic, and other occupational conditions) and non-occupational factors (demographic and lifestyle factors: nutritional status, diet, smoking, alcohol consumption, and physical activity). Despite its limitations, our study has identified occupational and non-occupational risk factors that can aggravate CTS and work disability, but which can also be improved with workplace and lifestyle preventive and corrective measures. More research is needed, though, to establish the possible causal relationships and the independent influence of each of those risk factors.
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Affiliation(s)
- Blerim Çupi
- Besa Meditor Primary Healthcare Centre, Oslomej, Kičevo, North Macedonia
- University of Niš Faculty of Medicine, Department of Occupational Health, Niš, Serbia
| | - Ivana Šarac
- University of Belgrade Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, Belgrade, Serbia
| | | | - Stefan Jovanović
- University of Niš Faculty of Medicine, Department of Occupational Health, Niš, Serbia
| | - Gordana Petrović-Oggiano
- University of Belgrade Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, Belgrade, Serbia
| | - Jasmina Debeljak-Martačić
- University of Belgrade Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, Belgrade, Serbia
| | - Jovica Jovanović
- University of Niš Faculty of Medicine, Department of Occupational Health, Niš, Serbia
- Institute of Occupational Medicine, Niš, Serbia
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Samant PD, Sane RM. Evaluation of Functional and Symptomatic Outcomes After Vitamin D 3 Administration in Carpal Tunnel Syndrome With Hypovitaminosis D. Hand (N Y) 2022; 17:1065-1069. [PMID: 33472438 PMCID: PMC9608297 DOI: 10.1177/1558944720988130] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vitamin D deficiency is now recognized as an independent risk factor and is involved in the pathogenesis of carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the effects of vitamin D3 supplementation on functional and symptomatic outcomes in CTS patients with vitamin D deficiency. METHODS This was a prospective, single-arm study with a pretreatment or posttreatment quasi-experimental design. Carpal tunnel syndrome patients with vitamin D deficiency were treated with vitamin D3 (60 000 IU/week) plus standard treatment for a period of 3 months. Carpal tunnel syndrome-related pain and functional and symptomatic outcomes were assessed at baseline and at 3 months posttreatment using the Visual Analogue Scale (VAS) and the Boston Carpal Tunnel Questionnaire, respectively, along with serum vitamin D. RESULTS A total of 42 patients were analyzed. At 3 months posttreatment, there was a significant reduction in the severity of pain (VAS score) from baseline (Z = -5.71, P < .001). Similarly, the functional and symptomatic outcomes (Boston symptoms severity scale [SSS] and Boston functional status scale [FSS] score) at 3 months posttreatment significantly improved in comparison with baseline (Boston SSS: Z = -5.66, P < .001; Boston FSS: Z = -5.68, P < .001). CONCLUSIONS Vitamin D3 supplementation was associated with improvement in functional and symptomatic outcomes and CTS-related pain in CTS with vitamin deficiency. However, further robust randomized controlled trials are warranted to validate the results.
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Anusitviwat C, Suwanno P, Suwannaphisit S. The effects of vitamin D supplementation in carpal tunnel syndrome treatment outcomes: a systematic review. J Exp Orthop 2021; 8:73. [PMID: 34490545 PMCID: PMC8421488 DOI: 10.1186/s40634-021-00393-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Vitamin D deficiency is related to carpal tunnel syndrome symptoms. Correcting vitamin D levels by supplementation was supposed to improve carpel tunnel symptoms, though there is a lack of aggregated data about treatment outcomes. This study aimed to examine whether vitamin D supplementation could improve the treatment outcomes in carpal tunnel syndrome patients. METHODS A comprehensive search of the PubMed, Cochrane Library, Scopus, and Web of Science databases for articles on vitamin D and carpel tunnel syndrome from January 2000 to March 2021 was performed. The article screening and data extraction were performed by two investigators independently with blinding to decisions on selected studies. All included studies had assessed the quality of evidence using the Methodological Index for Non-Randomized Studies (MINORS) scoring system. RESULTS We retrieved four studies that met the eligibility criteria. The treatment outcomes were evaluated by visual analog scale (124 wrists), functional scores (176 patients), muscle strength (84 patients), and nerve conduction velocity (216 wrists). After vitamin D supplementation, two studies reported improved pain scores and nerve conduction velocity, and three studies showed enhancement of functional status. CONCLUSION Vitamin D administration could offer favorable outcomes in pain improvement, better functional status, and increased sensory conduction velocity in carpal tunnel syndrome. However, there is to date no recommendations concerning a standardized dose or duration of vitamin D administration in carpal tunnel syndrome; prescribing vitamin D at the usual appropriate dose is suggested as an additional treatment in patients with mild to moderate carpel tunnel symptoms. LEVEL OF EVIDENCE Level IV, therapeutic study.
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Affiliation(s)
- Chirathit Anusitviwat
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla, 90110, Thailand
| | - Porames Suwanno
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla, 90110, Thailand
| | - Sitthiphong Suwannaphisit
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla, 90110, Thailand.
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