The Use and Alpha-Lipoic Acid (ALA), Gamma Linolenic Acid (GLA) and Rehabilitation in the Treatment of Back Pain: Effect on Health-Related Quality of Life

Abstract

The aim of this trial was to evaluate the effects of alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA) and the beneficial effect of physical exercise on positive sensory symptoms and neuropathic pain in patients with compressive radiculopathy syndrome from disc-nerve root conflict. Often these painful syndromes after the acute event, tend to recurr becoming subacute or chronic syndromes that become for the period of interest disabiling is an event very important in these cases proper prevention, based on a maintenance drug therapy and the strengthening exercises of paravertebral muscles, flexibility exercises on the spine and when needed on the reduction of body weight. In this Observational Cohort, two-arm trial, 203 patients were enrolled and divided into two groups, the first, ALA and GLA group, (n = 101) received oral dose of 600 mg of alpha-lipoic acid (ALA) and 360 mg of gamma-linolenic acid (GLA) and a rehabilitation program for six weeks, the second (n = 102) treated with only rehabilitation program. Patients were recruited at the centre of Physical Medicine and Rehabilitation, they underwent a physiatric examination at the primary outcome (t0) and secondary outcomes were recorded at monitoring visits scheduled at two weeks = t1, four weeks = t2, six weeks = t3, and at the same has been administered the following scale: VAS scale, SF-36, Oswestry Low Back Pain Disability Questionnaire, Aberdeen Back Pain Scale (ABPS), Revised Leeds Disability Questionnaire (LDQ), Roland and Morris Disability Questionnaire. Significant improvements was noted in the ALA and GLA group for paresthesia, stabbing and burning pain, as showed by VAS (Visual Analogue Scale), Oswestry Low Back Pain Disability Questionnaire, Aberdeen Low Back Pain Scale; also, improvements of quality of life has been noted, in the same group, as showed by SF-36, LDQ (Revised Leeds Disability Questionnaire), Roland and Morris disability questionnaire. All these outcome measure showed statistically significant decreases. Oral treatment with alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA) for six weeks in synergy with rehabilitation therapy improved neuropathic symptoms and deficits in patients with radicular neuropathy.

Fatty acid profile and oxidation tests of fat extracted from yogurt using rose hip seed oil

“…It would be desirable to enrich dairy products with polyunsaturated fatty acids, which are not synthesized in the human body, and the intake of which from food is often very poor. These acids have many health-promoting properties (Delgado-Lista et al, 2012;Kapoor and Huang, 2006;Ranieri et al, 2009). High levels of interest in the consumption of omega 3 fatty acids have made it possible to produce food fortified with EPA and DHA from marine sources (Kolanowski and Weiβbrodt, 2007;Rognlien et al, 2012).…”

Possible role of alpha-lipoic acid in the treatment of peripheral nerve injuries

“…Recent studies showed that treatment with α-LA reduced the pain, paresthesia, and numbness in symptomatic diabetic polyneuropathy [5], and in patients with compressive radiculopathy syndrome from disc-nerve root conflict [6]. The increase of oxidative stress could be one of the causes of the nerve damage characteristic of these types of neuropathy.…”

“…Therefore, the increase of SOD and CAT activities may be a response against oxidative stress. The results of Senoglu and colleagues correlated with our recent findings in which the combined employment of α-LA and γ-linolenic acid with a rehabilitation program for six weeks reduced sensory symptoms and neuropathic pain in patients with compressive radiculopathy syndrome from disc-nerve root in comparison with patients submitted to rehabilitation program alone for six weeks evaluating with Visual Analogue Scale, Short Form (36) Health Survey, Oswestry Low Back Pain Disability Questionnaire, Aberdeen Back Pain Scale, Revised Leeds Disability Questionnaire, and Roland and Morris Disability Questionnaire [6]. Although the mechanisms of nerve damage are unclear, it was hypothesized that both α-LA and SOD can increase their antioxidant protective actions.…”

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“…The safest, most effective, doses have been studied at 1200 to 1500 mg/day, with insignificant side effects reported at 1200mg/day. Other studies have demonstrated that alpha lipoic acid and Acetyl-L-Carnitineamalgamated, have been shown to improve pain and rejuvenate nerves with ALA doses at 300 to 600mg/day (Ranieri 2009). Both ALA and Acetyl L-Carnitine are powerful antioxidants and neuroprotectants, and together, have been known to increase energy levels.…”