α-Lipoic acid and superoxide dismutase in the management of chronic neck pain: a prospective randomized study.
OBJECTIVE
Since oxidative stress plays a pathogenetic role in chronic neck pain (CNP), we investigated whether a combination of α-lipoic acid (ALA) and superoxide dismutase (SOD) might improve pain control and the efficacy of physiotherapy ("multimodal therapy") in patients with CNP.


METHODS
This study was conducted in the Rehabilitation Unit of the Department of Surgical and Oncological Sciences at the University Policlinic in Palermo, Italy.


METHODS
This was a prospective, randomized, open study in outpatients.


METHODS
Patients randomly received either physiotherapy alone (group 2; n = 45) or a combination of ALA 600 mg and SOD 140 IU daily in addition to physiotherapy (group 1; n = 51), for 60 days. Pain was assessed by a visual analogue scale (VAS) and a modified Neck Pain Questionnaire (mNPQ). Treatment compliance and safety were also evaluated.


RESULTS
Both groups experienced a significant reduction in the VAS and mNPQ scores after 1 month; however, while no further improvement was observed in group 2 at 60 days, group 1 showed a further VAS reduction (p < 0.001). In addition, in the mNPQ at 60 days, more patients in group 1 than in group 2 reported that their neck pain was improved (p < 0.01), and they showed greater compliance with prescribed physiotherapy (p = 0.048). No drug reaction was observed.


CONCLUSIONS
Use of ALA/SOD in combination with physiotherapy may be a useful approach to CNP, being antioxidants that act on nerve inflammation and disease progression.


CONCLUSIONS
These preliminary observations suggest that some interesting goals (better pain control and physical wellbeing) can be achieved by multimodal therapy in CNP patients.
Cattedra di Medicina Fisica e Riabilitativa, Università degli Studi di Palermo, Via Del Vespro 127, 90127, Palermo, Italy, giulia.letiziamauro@unipa.it.
Giulia
G
Letizia Mauro
Pietro
P
Cataldo
Giuseppa
G
Barbera
Antonio
A
Sanfilippo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000188:drug therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000188:drug therapy*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D013482:Superoxide Dismutase / Q000008:administration & dosage*; D008063:Thioctic Acid / Q000008:administration & dosage*; D064232:Visual Analog Scale
D008063:Thioctic Acid; D013482:Superoxide Dismutase