The effects of vitamin D supplementation in carpal tunnel syndrome treatment outcomes: a systematic review

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

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

“…It is well known that physical inactivity, unhealthy diet, hypertension, and laboratory markers of inflammation and metabolic disorders are associated with increased BMI ( 101 , 102 , 103 ), which and may indirectly aggravate CTS through increased BMI ( 36 , 72 , 79 , 104 ), although direct effects cannot be excluded ( 77 , 93 , 94 , 95 , 97 , 105 ). The same goes for supplements; it is unclear if the correlations found are confounded by healthy lifestyle and normal BMI or there are more direct effects of certain micronutrients, as suggested by some studies ( 37 , 93 , 97 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 ). Therefore, further research is needed to establish a direct cause-effect relationship.…”

The Role of Vitamin D in the Treatment of Carpal Tunnel Syndrome: Clinical and Electroneuromyographic Responses

“…Regarding pain sensitivity, hypovitaminosis D is associated with nerve fiber hypersensitivity, coursing with persistent painful neuropathy [ 24 ]. Thus, studies suggest that vitamin D exerts its neuroprotective effect through the downregulation of L-type calcium channel expression or the upregulation of vitamin D receptor expression.…”

“…Preclinical experimental studies have shown that vitamin D acts on neuroprotective and neurotrophic functions and increases myelination and regeneration after peripheral nerve injury, which accelerates recovery and reduces neuronal damage [ 24 , 27 ]. Berridge [ 28 ] proposed that vitamin D acts by maintaining the integrity of cellular communication pathways.…”

“…Regardless of the specificity of the functional assessment instrument, the functional scores assessed in patients with CTS improved after vitamin D supplementation. However, the grip strength and the pinch strength, indirectly reflecting the muscles innervated by the median nerve, were not altered [ 24 ]. The research suggests that these different results may have been due to the very short period that vitamin D supplementation was given to affect motor functions [ 30 ].…”

Bilateral carpal tunnel syndrome revealing an acromegaly: a case report

“…Carpal tunnel syndrome (CTS) is a peripheral compression neuropathy. Its prevalence in the general population is about 3-5% [ 2 ]. In acromegaly, CTS is a common complication.…”