Evaluation of Functional and Symptomatic Outcomes After Vitamin D₃ Administration in Carpal Tunnel Syndrome With Hypovitaminosis D

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.

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.…”

“…The mean age of patients was between 40 to 60 years, with females predominate even considering one report which did not distinguish between genders [26]. Before vitamin supplementation, three studies reported on the severity of CTS as mild or moderate [26, 35, 36]. Previous and ongoing treatment of CTS were analgesics, anti‐inflammatory drugs, splint, physiotherapy, and carpal tunnel release [21, 26, 35, 36].…”

“…Previous and ongoing treatment of CTS were analgesics, anti‐inflammatory drugs, splint, physiotherapy, and carpal tunnel release [21, 26, 35, 36]. 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].…”

“…All studies used combined clinical conditions and nerve conduction velocity to assess the treatment outcomes, except for one study that used only clinical evaluations [36]. The treatment outcomes were evaluated by visual analog scale (VAS) in 124 wrists of 97 patients, functional scores in 176 wrists of 176 patients, [35,36]. Contrary to the pain scores, there were no statistically significant differences in motor power and median motor conduction velocity.…”