title: Comparison of shock wave therapy and nutraceutical composed of Echinacea angustifolia, alpha lipoic acid, conjugated linoleic acid and quercetin (perinerv) in patients with carpal tunnel syndrome.
abstract: Even though the initial treatment of carpal tunnel syndrome (CTS) is conservative, knowledge of the clinical effects of supplements and of some methods of physiotherapy is still preliminary. Many biological mechanisms can support the administration of shock wave therapy (ESWT) or of alpha lipoic acid (ALA) based nutraceutical, conjugated linoleic acid (GLA), anti-oxidants and Echinacea angustifolia for CTS. The shock waves reduce the nerve compression, produce an anti-inflammatory action, and accelerate the regeneration of neuropathy. ALA and GLA induce antioxidant protective actions, reduce inflammation, promote neuroregeneration, and decrease pain. The Echinacea modulates the endogenous cannabinoid system.The aim of study is to verify the efficiency of shock wave therapy versus nutraceutical composed of ALA, GLA, and Echinacea in CTS. Sixty patients were enrolled in this study and they were randomly assigned to one of two treatments. Both groups showed significant improvements in pain, symptoms' severity and functional scores, and electrodiagnostic results until the sixth month. We verified a trend to a better pain regression in the nutraceutical group. The presence of the medicinal Echinacea represents an added value to the antioxidant effect in ALA and GLA, which can justify this result. ESWT or the association of ALA, GLA, and Echinacea proved to be two effective treatments for controlling symptoms and improving the evolution of CTS.
authors.affiliation: Course of Motor and Sports Sciences, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, Bari, Italy Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy angelanotarnicola@yahoo.it.
authors.forename: Angela
authors.initials: A
authors.lastname: Notarnicola
authors.affiliation: Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Maccagnano
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Faculty of Medicine and Surgery, University of Study of Bari, Bari, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Tafuri
authors.affiliation: Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fiore
authors.affiliation: Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Pesce
authors.affiliation: Course of Motor and Sports Sciences, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, Bari, Italy Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Bari, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Moretti
mesh_terms: D000975:Antioxidants / Q000627:therapeutic use; D002349:Carpal Tunnel Syndrome / Q000188:drug therapy*; D019587:Dietary Supplements; D020900:Echinacea / Q000737:chemistry*; D019220:High-Energy Shock Waves; D006801:Humans; D044243:Linoleic Acids, Conjugated / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011794:Quercetin / Q000627:therapeutic use*; D008063:Thioctic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D044243:Linoleic Acids, Conjugated; D008063:Thioctic Acid; D011794:Quercetin
keywords: carpal tunnel syndrome; dietary supplements; shock waves