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

A Hand Therapist’s Role in Nutrition Education for Wound Healing

October 18, 2020

By Brittany Day Role of nutrition in wound healing Nutrition plays an important function in the biological factors that contribute to normal wound healing (wound care nutrition). Patients without nutrient dense diets may experience diminished cell production, collagen synthesis, and wound contraction.  There is sparse scientific evidence that explores the exact science behind nutrition and…

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).…

Is HEP Just as Good as Therapy for Metacarpal Fracture Rehab?

July 7, 2019

Gülke, J., Leopold, B., Grözinger, D., Drews, B., Paschke, S., & Wachter, N. J. (2018). Postoperative treatment of metacarpal fractures – Classical physical therapy compared with a home exercise program. Journal of Hand Therapy, 31(1), 20-28. The Skinny – Medicine is moving towards a model that encourages less direct intervention and a more DIY focus…

THUMB ABDUCTION IN PATIENTS WITH CMC ARTHRITIS? HOW DO YOU MEASURE?

March 28, 2021

Article Review THUMB ABDUCTION IN PATIENTS WITH CMC ARTHRITIS? HOW DO YOU MEASURE?  Corey McGee PhD, OTR/L, CHT , Virginia O’Brien OTD, OTR/L, CHT , Jennifer Skye MS, OTR/L, CHT , Katherine Wall MOT, OTR/L , Thumb Carpometacarpal Palmar and CMC Radial Abduction in Adults with Thumb Carpometacarpal Joint Pain: Inter-rater Reliability and Precision of…

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.