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Background and objective <p>Carpal tunnel syndrome (CTS) is a median nerve compression at the wrist, leading to mild to severe pain, numbness, and tingling in the hand. It is the most common entrapment neuropathy, affecting 4% to 5% of people worldwide. This systematic review aimed to&#xa0;assess the effectiveness of dietary supplements for CTS for of pain relief and improve function. The supplements examined included vitamin B6, vitamin D, alpha-lipoic acid, palmitoylethanolamide (PEA), astaxanthin, and their combinations.</p> Materials and methods <p>PubMed, Cochrane (CENTRAL), Web of Science (WOS), and Scopus databases were searched for randomized controlled trials (RCTs) that assessed the effectiveness of dietary supplements for CTS. Two researchers independently screened titles, abstracts, and full-text articles. Methodological quality was evaluated using the revised Cochrane Collaboration tool (RoB 2.0) because of the high risk of bias in the methodological quality of the included studies and the heterogeneity of the interventions. We used Cohen's d as the effect estimate and employed vote counting based on the direction of effect as the synthesis method.</p> Results <p>We included eight RCTs (<i>n</i> = 644 patients). The mean age of participants across the studies ranged from 42.7 to 69&#xa0;years, with a slightly greater proportion of females. We observed significant pain reduction with multiple interventions in the vitamin D (2000&#xa0;IU/day) combined with corticosteroids. Vitamin B6 interventions significantly improved median nerve sensory conduction velocity and sensory amplitude while decreasing latency. PEA treatment showed insignificant improvement in pain scores or electrophysiological parameters. Astaxanthin supplementation combined with splinting showed insignificant effect over placebo for functional outcomes. The combination of complex antioxidants (acetyl-L-carnitine, α-lipoic acid, curcumin, and vitamins) significantly improved both pain (VAS scores) and symptom severity.</p> Conclusion <p>There is limited evidence that dietary supplements may offer therapeutic benefits for patients with CTS, supporting their use either alone or in combination with standard treatment. However, further larger and higher-quality studies are necessary to confirm their effectiveness.</p> PROSPERO Registration Number <p>CRD42024598285.</p> Graphical abstract <p></p>

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A systematic review of the effectiveness of dietary supplements for carpal tunnel syndrome

  • 期刊论文

  • 发表日期：

    2025年6月24日

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  • Ahmed Samir,
  • Soumaya M. Elghoul,
  • Hagar Ibrahim,
  • Mayar Othman,
  • Ahmed Abdullah,
  • Islam Saeed Elhois,
  • Ibrahim Moqbel

摘要

Background and objective

Carpal tunnel syndrome (CTS) is a median nerve compression at the wrist, leading to mild to severe pain, numbness, and tingling in the hand. It is the most common entrapment neuropathy, affecting 4% to 5% of people worldwide. This systematic review aimed to assess the effectiveness of dietary supplements for CTS for of pain relief and improve function. The supplements examined included vitamin B6, vitamin D, alpha-lipoic acid, palmitoylethanolamide (PEA), astaxanthin, and their combinations.

Materials and methods

PubMed, Cochrane (CENTRAL), Web of Science (WOS), and Scopus databases were searched for randomized controlled trials (RCTs) that assessed the effectiveness of dietary supplements for CTS. Two researchers independently screened titles, abstracts, and full-text articles. Methodological quality was evaluated using the revised Cochrane Collaboration tool (RoB 2.0) because of the high risk of bias in the methodological quality of the included studies and the heterogeneity of the interventions. We used Cohen's d as the effect estimate and employed vote counting based on the direction of effect as the synthesis method.

Results

We included eight RCTs (n = 644 patients). The mean age of participants across the studies ranged from 42.7 to 69 years, with a slightly greater proportion of females. We observed significant pain reduction with multiple interventions in the vitamin D (2000 IU/day) combined with corticosteroids. Vitamin B6 interventions significantly improved median nerve sensory conduction velocity and sensory amplitude while decreasing latency. PEA treatment showed insignificant improvement in pain scores or electrophysiological parameters. Astaxanthin supplementation combined with splinting showed insignificant effect over placebo for functional outcomes. The combination of complex antioxidants (acetyl-L-carnitine, α-lipoic acid, curcumin, and vitamins) significantly improved both pain (VAS scores) and symptom severity.

Conclusion

There is limited evidence that dietary supplements may offer therapeutic benefits for patients with CTS, supporting their use either alone or in combination with standard treatment. However, further larger and higher-quality studies are necessary to confirm their effectiveness.

PROSPERO Registration Number

CRD42024598285.

Graphical abstract