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

Abstract

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.

The evaluation of the effect of vitamin D replacement on the symptoms of carpal tunnel syndrome in patients with low vitamin D levels

“…A similar study was conducted by Tanik et al [24], in which the authors found a positive correlation between the severity of Vit D deficiency and the severity of CTS. In a study by Sacmaci et al [21], involving 50 female patients (45 wrists with mild CTS and 37 wrists with moderate CTS), an improvement in nerve conduction values was reported in both groups. Shortening in median nerve distal sensory onset latency (DSOL) and an increase in SCV were found to be statistically significant in the mild CTS group.…”

“…Akyuz et al [22] reported a significant improvement in pain and quality of life after eight-weeks of Vit D treatment in patients with chronic widespread pain; however, they further examined the patients electrophysiologically and did not identify any significant changes in nerve conduction studies following the Vit D supplementation. In a study by Sacmaci et al [21] involving 50 female patients (45 wrists with mild CTS and 37 wrists with moderate CTS), an improvement was observed in both groups after treatment compared to pretreatment. Consistent with these findings, in the present study, a statistically significant improvement was observed in both day and night VAS scores of both groups after the treatment.…”

“…In a study by Shebab et al [20] in 2015 investigating the effects of Vit D on peripheral neuropathy, 112 patients with type II DM accompanied by peripheral neuropathy were given 50,000 IU cholecalciferol once a week for eight weeks and the authors reported a significant increase in Vit D levels and a significant improvement in neuropathy symptom scores in the treatment group compared to the placebo group at the end of eight weeks. In a recent study by Sacmaci et al [21], Vit D values of patients with moderate CTS were reported to improve at the end of the third month after replacement therapy compared to pre-treatment. Similar to this study, we found a statistically significant increase in posttreatment Vit D levels of both groups.…”

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

“…Serum vitamin D levels increased significantly after vitamin supplement in the three studies which reported this [ 21 , 35 , 36 ], whereas one study did not detail the vitamin D level after supplementation [ 26 ]. The doses of oral vitamin D varied in each study, ranging from 7000 to 60,000 IU/week with a duration of 12 weeks in three studies [ 26 , 35 , 36 ] and 24 weeks in one study [ 21 ]. These clinical data and interventions in each included study are presented in Table 2 .…”

“…The treatment outcomes were evaluated by visual analog scale (VAS) in 124 wrists of 97 patients, functional scores in 176 wrists of 176 patients, muscle strength in 84 wrists of 84 patients, and nerve conduction velocity in 216 wrists of 189 patients. CTS symptoms as evaluated by VAS scores were decreased significantly in two studies [ 35 , 36 ]. Contrary to the pain scores, there were no statistically significant differences in motor power and median motor conduction velocity.…”