Does vitamin D deficiency trigger carpal tunnel syndrome?

Shehta

Egypt J Neurol Psychiatry Neurosurg

et al. 2018

BackgroundCarpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. The aim of this study is to evaluate the body mass index (BMI) and vitamin D levels in CTS patients.MethodsThe current study was conducted at Zagazig University Hospitals. It included 50 CTS patients and 50 controls. Clinical assessment was carried out to exclude symptoms and signs of neuropathy. Laboratory investigations including vitamin D levels, glycosylated hemoglobin, liver, and kidney function were carried out for every participant. All patients underwent electrodiagnostic study and completed Boston questionnaire to assess their pain sum score, symptom severity (SSS), and functional status (FSS).ResultsPatients had significantly higher BMI and lower vitamin D levels compared to controls (p = 0.003 and p = 0.001, respectively). Those with severe CTS had a significantly higher BMI and lower vitamin D levels than the others (p = 0.03 and p = 0.01 respectively). No significant difference was found between CTS subgroups regarding the SSS, while a higher significant FSS and pain sum score were reported in the severe CTS patients compared to the other two groups (p = 0.01 and p = 0.04 respectively). A significant negative correlation was detected between vitamin D levels and both of BMI, and Boston pain sum scores (p = 0.01 and p = 0.03 respectively). Also, an inverse correlation was detected between vitamin D levels and both of SSS and FSS (p = 0.14, p = 0.06). Furthermore, a significant positive and negative correlation between vitamin D levels and both of conduction velocity and distal motor latency respectively was observed (p = 0.02 and p = 0.01 respectively).ConclusionsCarpal tunnel syndrome was significantly associated with hypovitaminosis D especially in patients with higher BMI. This highlights the importance of vitamin D supplements and weight loss regimes to minimize the severity of their pain.

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 93%

Body mass index and vitamin D level in carpal tunnel syndrome patients

Shehta

Egypt J Neurol Psychiatry Neurosurg

et al. 2018

“…TNF and macrophage-microglia, which cause sensitization of the peripheral and central nervous system and inhibit the stimulating mechanism 22 . Donato and colleagues emphasized that vitamin D plays a role in anti-VEGF agent and it may be the first line treatment because it is cheap and effective in the treatment of CTS 4 .…”

Section: Discussionmentioning

confidence: 99%

Electrophysiological evaluation of carpal tunnel syndrome female patients after vitamin D replacement

Saçmacı

Tanık

Balbaloğlu

et al. 2020

Arq. Neuro-Psiquiatr.

Self Cite

Objective: The effects of vitamin D on the central and peripheral nervous system continue to be investigated today. In the present study, we aimed to evaluate pain and electrophysiologic response in patients with carpal tunnel syndrome (CTS) who have undergone replacement therapy due to vitamin D deficiency. Methods: Fifty female patients diagnosed with mild and moderate CTS and accompanied by vitamin D deficiency were included in this study. Nerve conduction study (NCS) was performed before and after vitamin D replacement, and the patient’s pain was evaluated with Visual Analogue Scale (VAS). Results: When NCS were compared before and after treatment, there was a statistically significant improvement in the median distal sensory onset latency (DSOL) and sensory conduction velocity (CV) and motor distal latencies (DML) values (p=0.001; p<0.001; p=0.001, respectively). At the same time, there was a decrease in the VAS values in patients (p<0.001). When the two groups were compared there was an improvement in DSOL and sensory CV in both groups, but in DML only in moderate CTS group. Conclusion: In this study, it was shown that mild and moderate CTS patients had an improvement in pain and electrophysiological parameters after vitamin D replacement. Replacing vitamin D in early stages of CTS may be beneficial.

“…There are very scarce data on the role of vitamin D in neuropathic pain. One observational study has shown possible associations between vitamin D deficiency and carpal tunnel syndrome [ 17 ], and an interventional study showed positive effect on diabetic neuropathy after a very high single-dose of vitamin D [ 18 ]. However, in this review we will focus on the role of vitamin D in nociceptive and inflammatory pain.…”

Section: Definitions Of Painmentioning

confidence: 99%

Vitamin D in Pain Management

Frankling

Björkhem‐Bergman

2017

IJMS

110

Vitamin D is a hormone synthesized in the skin in the presence of sunlight. Like other hormones, vitamin D plays a role in a wide range of processes in the body. Here we review the possible role of vitamin D in nociceptive and inflammatory pain. In observational studies, low vitamin D levels have been associated with increased pain and higher opioid doses. Recent interventional studies have shown promising effects of vitamin D supplementation on cancer pain and muscular pain—but only in patients with insufficient levels of vitamin D when starting intervention. Possible mechanisms for vitamin D in pain management are the anti-inflammatory effects mediated by reduced cytokine and prostaglandin release and effects on T-cell responses. The recent finding of vitamin D-mediated inhibition of Prostaglandin E2 (PGE2) is especially interesting and exhibits a credible mechanistic explanation. Having reviewed current literature, we suggest that patients with deficient levels defined as 25-hydroxyvitamin D (25-OHD) levels <30 nmol/L are most likely to benefit from supplementation, while individuals with 25-OHD >50 nmol/L probably have little benefit from supplementation. Our conclusion is that vitamin D may constitute a safe, simple and potentially beneficial way to reduce pain among patients with vitamin D deficiency, but that more randomized and placebo-controlled studies are needed before any firm conclusions can be drawn.