Does Taking an Alpha-lipoic for 40 days after Carpal Tunnel Release decrease the likelihood of developing Pillar Pain?

Filippo, B., Granchi, D., Roatti, G., Merlini, L., Sabattini, T., & Baldini, N. (2017). Alpha-lipoic acid after median nerve decompression at the carpal tunnel: A randomized controlled trial. The Journal of Hand Surgery, 4, 236–42.

The Skinny – A double-blind, randomized controlled study was performed. Sixty-four patients were randomly assigned into two groups after median nerve decompression. Thirty-two patients took the alpha-lipoic acid (ALA), while the other 32 received the placebo pill. 

pillar pain

In The Weeds – The outcome measures utilized were Boston Carpal Tunnel score, 2-point discrimination, presence or absence of pillar pain, use of analgesics beyond post-op day 2, and sensory and motor conduction velocities.   These measures were assessed at three months post-op. 

Bringing it Home –  ALA did not significantly improve nerve conduction velocity or Boston Carpal Tunnel score. Taking ALA did reduce pillar pain, and static 2-point discrimination improved in both groups. 

Taking ALA for 40 days after carpal tunnel surgery can lower the incidence of Pillar Pain.   The study size was relatively small, and the outcome measures of pain and two-point discrimination test are somewhat subjective measures. The ALA treatment (pillar pain treatment) was well tolerated by the study participants. A larger study is needed to confirm these findings. 

Leave a Comment






More To Read

Closed Pulley Injuries in Rock Climbers

August 21, 2025

Mechanism of injury  Grades of pulley injury  Treatment options for closed rupture  Outcome measures  Return to climbing  Exercise considerations  Resources Bollen S. R. (1990). Upper limb injuries in elite rock climbers. Journal of the Royal College of Surgeons of Edinburgh, 35(6 Suppl), S18–S20. Bosco, F., Giustra, F., Lusso, A., Faccenda, C., Artiaco, S., & Massè, A. (2022).…

Putting Occupation in Hand Therapy

February 5, 2019

It was early in my career, maybe a year out of school. I was working with a veteran physical therapist that had been practicing for thirty plus years. She was somewhat intimidating and one of those old school physical therapists that thrived on being aggressive. We were chatting about what areas of occupational hand therapy…

Prevention and Management of Upper Extremity injuries in Modern Mass Production

November 3, 2024

Injuries and Upper Extremty Pitts, G., Custer, M., Foister, R. D., & Uhl, T. (2021). The hand therapist’s role in the preventionand management of upper extremity injuries in the modern mass production industrial setting.Journal of Hand Therapy, 34(2), 237–249. https://doi.org/10.1016/j.jht.2021.04.019 By: Kaylen Kallander The Skinny: This study included four case studies to determine the impact…

Soft Tissue Healing in Pediatrics

May 3, 2020

By: Chelsea Gonzalez Why do pediatric clients often not require as much hand therapy for soft tissue injuries when compared to adults? The simple answer: Kids have very elastic soft tissue, which can return to its original shape and position after stretch. This elasticity is lost with time as collagen fibers expand and their internal…

Envelope_1

Sign-up to Get Updates Straight to Your Inbox!

Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.