Abstract
PurposeVitamin D deficiency is related to carpal tunnel syndrome symptoms. Correcting vitamin D levels by supplementation was supposed to improve carpel tunnel symptoms, though there is a lack of aggregated data about treatment outcomes. This study aimed to examine whether vitamin D supplementation could improve the treatment outcomes in carpal tunnel syndrome patients.MethodsA comprehensive search of the PubMed, Cochrane Library, Scopus, and Web of Science databases for articles on vitamin D and carpel tunnel syndrome from January 2000 to March 2021 was performed. The article screening and data extraction were performed by two investigators independently with blinding to decisions on selected studies. All included studies had assessed the quality of evidence using the Methodological Index for Non-Randomized Studies (MINORS) scoring system.ResultsWe retrieved four studies that met the eligibility criteria. The treatment outcomes were evaluated by visual analog scale (124 wrists), functional scores (176 patients), muscle strength (84 patients), and nerve conduction velocity (216 wrists). After vitamin D supplementation, two studies reported improved pain scores and nerve conduction velocity, and three studies showed enhancement of functional status.ConclusionVitamin D administration could offer favorable outcomes in pain improvement, better functional status, and increased sensory conduction velocity in carpal tunnel syndrome. However, there is to date no recommendations concerning a standardized dose or duration of vitamin D administration in carpal tunnel syndrome; prescribing vitamin D at the usual appropriate dose is suggested as an additional treatment in patients with mild to moderate carpel tunnel symptoms.Level of EvidenceLevel IV, therapeutic study
Highlights
Carpal tunnel syndrome (CTS), peripheral compressive neuropathy of the median nerve in the wrist, is a common disease with a reported uptrend in incidence [5]
Some studies have reported a potential linkage between CTS and vitamin D levels, and Vitamin D deficiency is recognized as an independent risk factor for increasing severity of CTS symptoms, tingling pain and nerve function [4, 10, 37]
Apart from the effect on neurologic function, vitamin D plays a role in suppressing the vascular endothelial growth factor associated with increased inflammatory fibrosis, which may have a role in triggering CTS [16, 17]
Summary
Carpal tunnel syndrome (CTS), peripheral compressive neuropathy of the median nerve in the wrist, is a common disease with a reported uptrend in incidence [5]. Some studies have reported a potential linkage between CTS and vitamin D levels, and Vitamin D deficiency is recognized as an independent risk factor for increasing severity of CTS symptoms, tingling pain and nerve function [4, 10, 37]. The reason for this connection is that vitamin D, in the form of D2 (ergocalciferol) or D3 (cholecalciferol), has neuroprotection and neurotrophic functions, and improves nerve myelination which hastens recovery after nerve injuries [8, 9, 27]. In relation to pain perception, low vitamin D is related to hypersensitivity of nerve fibers leading to persistent painful neuropathy [10, 20]
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