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Carpal tunnel syndrome and low vitamin D

VitaminDWiki

Vitamin D does relieve pain and inflammation
Might try topical vitamin D (cream, spray, patch or oil) directly on the CTS
See also VitaminDWiki

Pages listed in BOTH the categories Intervention and Pain


Carpal Tunnel Syndrome relief for 24% getting 600,000 IU injection of Vitamin D

Role of vitamin- D in carpal tunnel syndrome
Shailesh Gupta1’guptahandsurgery@gmail.com, Ravindra Gupta2
Consultant, Gupta Hand Surgery Centre, Indore, Madhya Pradesh, 2Assistant Professor, Index Medical College, Indore, Madhya
Pradesh

VitaminDWiki

24% had substantial relief to full relief of CTS (12 out of 50) and deferred CTS surgery

  • Duration of symptoms was 1 month to 1 year (avg 6 months)
  • Associated medical illness: hypothyroidism in 4 patients & diabetes in 9 patients
  • 19 patients had no significant relief but for now they opted for conservative management (inj corticosteroid with night splints in 11 patients & only night splints in 8 patients)
  • 8 patients ultimately underwent surgery to get relief from symptoms

 Download the PDF from VitaminDWiki

In order to evaluate the effect of vitamin D3 we have evaluated around 50 patients in whom vitamin D deficiency was found & were suffering from CTS. They were all given deep intramuscular 6 lakhs unit of vitamin D. Out of this 12 patients had a substantial relief to full relief in whom surgery was deffered. The idea of writing this paper was a further study is warranted to prove its larger role in many compressive neuropathies & metabolic neuropathies if it can lead to clinical improvement in patients can save some of them from surgery

Cliped from PDF
CTS may be classified into three stages:

  • Mild: less than 1 year duration with absent weakness & atrophy with normal two point discrimination & EmG & NCV
  • Moderate: duration may be less than or more than 1 year. Minimal presence of weakness & atrophy. Possible abnormality in two point discrimination examination. No to mild denervation in EMG test. No to mild decrease in velocity in NCV testing.
  • Severe: duration is more than 1 year. Marked presence of weakness & atrophy. Marked abnormality in two point discrimation on examination.


During 1st author’s yearly regular health check-up a deficiency of vitamin D was diagnosed. His level was 7 (normal reference range 30 to 100). So 1st author took an injection of 6 lakh unit of vitamin D3 (cholecalciferol) deep intramuscular. To author’s surprise the tingling & numbness disappeared suddenly. Till now 1.5 year has been passed & he is still asymptomatic.

Rest is in the PDF


Carpal Tunnel Syndrome is associated with both low vitamin D and few receptors– Jan 2018

Expression of vitamin D receptor in the subsynovial connective tissue in women with carpal tunnel syndrome.
J Hand Surg Eur Vol. 2018 Jan 1:1753193417749158. doi: 10.1177/1753193417749158. [Epub ahead of print]
Kim K1, Gong HS2, Kim J2, Baek GH2.

VitaminDWiki

Measurements were made at the time of Carpal Tunnel Surgery

 Download the PDF from Sci-Hub.tw via VitaminDWiki

Studies suggest that low vitamin D levels are associated with carpal tunnel syndrome. We aimed to evaluate whether level of vitamin D receptor expression in the endothelial cells of the subsynovial connective tissue is associated with clinical features of carpal tunnel syndrome. We obtained the subsynovial connective tissue from 52 women with carpal tunnel syndrome during surgery and performed immunohistochemical analysis of vitamin D receptors in the endothelial cells of the subsynovial connective tissue. We explored correlation of vitamin D receptor expression with clinical features of carpal tunnel syndrome, such as age, symptom duration, symptom severity and electrophysiological severity. Diverse range of vitamin D receptor expression was observed. Vitamin D receptor expression was independently associated with distal motor latency.
This suggests that vitamin D receptor expression may be associated with disease progression, as prolonged distal motor latency reflects severity of the disease. Further studies are necessary to explore the role of vitamin D and vitamin D receptors in patients with carpal tunnel syndrome.

LEVEL OF EVIDENCE: IV.

PMID: 29329504 DOI: 10.1177/1753193417749158


Vitamin D levels much lower if CTS - May 2017

The Effect of Vitamin D Levels on Pain In Carpal Tunnel Syndrome.
Orthop Traumatol Surg Res. 2017 May 25. pii: S1877-0568(17)30142-1. doi: 10.1016/j.otsr.2017.05.003. [Epub ahead of print]
Demiryurek BE1, Gundogdu AA2.

BACKGROUND:
Carpal tunnel syndrome (CTS) and vitamin D deficiency are two discrete common clinical pictures that can cause chronic pain. In this study, we aimed to evaluate the association of 25 (OH) D deficiency with electrophysiological findings and severity of pain in patients with mild CTS.
METHOD:
The consecutive patients admitted to our laboratory with the symptoms of CTS between May 2016 and August 2016 were enrolled in this study. According to their electrophysiological examination results, only the patients with normal conduction results and ones with mild grade CTS were included. Demographic data, the results of the electrophysiological studies, vitamin D levels (our laboratory normal is > 20 ng / mL), duration of pain and pain intensity due to CTS which was assessed with visual analog scale were collected.
RESULTS:
Totally, 76 patients (36 patients with mild CTS and 40 without CTS) were included. In the mild CTS patients, vitamin D levels were significantly lower than those electrophysiologically normal patients (p = 0.003). The relationship between gender, duration of pain and vitamin D levels were evaluated in the normal and mild CTS group. There was no significant relationship between the pain and vitamin D levels in the normal group, while vitamin D level was significantly lower in the mild CTS group (p = 0.730 and p = 0.002; respectively).
DISCUSSION:
Vitamin D deficiency increases the pain intensity in patients with CTS. Treatment of vitamin D deficiency in these patients may play a role in pain relief. Further studies involving analyses of post-Vitamin D replacement therapy are warranted to confirm the association between vitamin D deficiency and pain due to CTS.

PMID: 28552837 DOI: 10.1016/j.otsr.2017.05.003 Publisher wants $36 for the PDF
Revies of study by Vitamin D Council June 2017
Note that CTS pain decreases with increased Vitamin D
Image


Carpal tunnel syndrome triggered by low vitamin D - March 2016

Does vitamin D deficiency trigger carpal tunnel syndrome?
J Back Musculoskelet Rehabil. 2016 Mar 31.
Tanik N1, Balbaloğlu Ö2, Ucar M2, Sarp U3, Atalay T4, Çelikbilek A1, Göçmen AY5, Inan LE1.
1Department of Neurology, Bozok University Medical School, Yozgat, Turkey.
2Department of Physical Treatment and Rehabilitation, Bozok University Medical School, Yozgat, Turkey.
3Department of Physical Medicine and Rehabilitation, Yozgat State Hospital, Yozgat, Turkey.
4Department of Neurosurgery, Bozok University Medical School, Yozgat, Turkey.
5Department of Biochemistry, Bozok University Medical School, Yozgat, Turkey.

OBJECTIVE:
Vitamin D deficiencies are associated with a variety of chronic diseases. The goal of the present study was to investigate the relationship between vitamin D levels and carpal tunnel syndrome (CTS).
METHODS:
This study included 90 patients with mild to moderate CTS and assessed their routine serum 25-hydroxyvitamin D levels. Additionally, the pain level of each subject was evaluated using the Visual Analogue Scale and the Douleur Neuropathique 4 Questionnaire (DN4).
RESULTS:
The severity levels of CTS were at a 75% mild level in the vitamin D deficiency group and a 47.1% mild level in the vitamin D normal group, with a significant difference between groups (p = 0.008). Correlation analyses revealed positive correlations between body mass index and DN4 scores (r = 0.499, p = 0.025) and between vitamin D levels and CTS severity (r = 0.364, p = 0.004) in the vitamin D deficiency group.
CONCLUSIONS:
The present findings demonstrated that CTS may be triggered by vitamin D deficiency, and that the severity of CTS was correlated with vitamin D levels in the deficiency group. Additionally, there was a correlation between weight gain and neuropathic pain intensity in CTS patients with vitamin D deficiency. The present findings indicate that vitamin D levels should be assessed in CTS patients.

PMID: 27062466

Review of this study by Vitamin D Council May 2016


Could Vitamin D be Linked to Carpal Tunnel Syndrome? MedPageToday

Reporting on poster at American Society for Bone and Mineral Research meeting. (Oct 9-12, 2015)
Women (< age 50) with carpal tunnel release had vitamin D levels of 17 nanograms
Control women had vitamin D levels of 21 nanograms

The association did not exist for women > 50 years old
Publisher wants $40 for the PDF of the published paper Dec 2015


The evaluation of vitamin D levels in patients with carpal tunnel syndrome - March 2016

Neurological Sciences, pp 1-7
Azize Esra Gürsoy , Halide Rengin Bilgen, Hümeyra Dürüyen, Özge Altıntaş, Mehmet Kolukisa, Talip Asil, Azize Esra Gürsoy
1. Department of Neurology, Medical Faculty, Bezmialem Vakif University, Vatan Caddesi, Fatih, 34093, Istanbul, Turkey
2. Department of Neurology, Şişli Etfal Education and Research Hospital, Istanbul, Turkey
3. Department of Neurology, Niğde-Bor State Hospital, Niğde, Turkey

Publisher wants $39.95 / €34.95 / £29.95 for the PDF

The aim of this study was to evaluate the relationship between 25-hydroxyvitamin D (25(OH)D) levels and carpal tunnel syndrome (CTS). 25(OH)D levels were checked in 108 consecutive patients with CTS symptoms and 52 healthy controls. All patients underwent nerve conduction studies and completed Boston Carpal Tunnel Questionnaire (BQ) symptom severity and functional status scales to quantify symptom severity, pain status and functional status. There were 57 patients with electrophysiological confirmed CTS (EP+ group) and 51 electrophysiological negative symptomatic patients (EP− group). 25(OH) D deficiency (25(OH)D < 20 ng/ml) was found in 96.1 % of EP− group, in 94.7 % of EP+ group and in 73.8 % of control group. 25(0H) D level was found significantly lower both in EP+ and EP− groups compared to control group (p = 0.006, p < 0.001, respectively). Although mean vitamin D level in EP− group was lower than EP+ group, statistically difference was not significant between EP+ and EP− groups (p = 0.182). BQ symptom severity and functional status scores and BQ pain sum score were not significantly different between EP+ and EP− groups. We found no correlation with 25(OH) D level for BQ symptom severity, functional status and pain sum scores. 25(OH) D deficiency is a common problem in patients with CTS symptoms. As evidenced by the present study, assessment of serum 25(OH)D is recommended in CTS patients even with electrophysiological negative results.
References are online, free

95% of people with CTS had Vitamin D <20 ng (vs 74% of people without CTS)


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Attached files

ID Name Comment Uploaded Size Downloads
9183 Role of vitamin- D in carpal tunnel syndrome.pdf PDF 2017 admin 14 Jan, 2018 16:37 191.93 Kb 29
9182 Carpal VDR Sci-Hub.pdf PDF 2018 admin 14 Jan, 2018 16:13 338.44 Kb 34
8157 CTS pain.JPG admin 07 Jul, 2017 10:37 19.33 Kb 559
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