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

Differential Diagnosis: Trigger Finger vs. Subluxing Sagittal Band Injury vs. Subluxing Lateral Band

June 28, 2025

Differential Diagnosis: Trigger Finger vs. Subluxing Sagittal Band Injury vs. Subluxing Lateral Band Hand therapists frequently encounter patients presenting with finger pain, clicking, and difficulty with tendon glide. Among the most commonly confused conditions are trigger finger, subluxing sagittal band injury, and subluxing lateral band.  Each of these pathologies involves different anatomical structures and biomechanical…

How to use Kinesiology Taping for Shoulder Subluxation

February 9, 2024

How to us Kinesiology Tape for Shoulder Subluxation By: Tayler Roost What is shoulder subluxation?  Shoulder subluxation is a dislocation of the glenohumeral joint. This can be classified as traumatic, non-traumatic, or neurological. A traumatic shoulder subluxation can be caused by contact sports or repetitive shoulder movements. A non-traumatic shoulder subluxation can be caused indirectly…

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…

“Do joint mobilizations assist in the recovery of lateral elbow tendinopathy? A systematic review and meta-analysis”

January 10, 2021

By Sophia Grimm Lucado, A. M., Dale, R. B., Vincent, J., & Day, J. M. (2019). Do joint mobilizations assist in the recovery of lateral elbow tendinopathy? A systematic review and meta-analysis. Journal of hand therapy : official journal of the American Society of Hand Therapists, 32(2), 262–276.e1. https://doi.org/10.1016/j.jht.2018.01.010 The Skinny: The purpose of this study was…

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.