title: Use of palmitoylethanolamide in carpal tunnel syndrome: a prospective randomized study.
abstract: BACKGROUND
  Palmitoylethanolamide (PEA) is an endogenous fatty acid amide that has shown anti-inflammatory activity and neuroprotection and has been used for the treatment of compressive syndromes. The aim of this study is to investigate the clinical and electrophysiological effects of conservative treatment with PEA in low to moderate carpal tunnel syndrome (CTS).
  
  
  METHODS
  A prospective double-blinded randomized study was performed on 61 patients with a clinical and electrophysiologically confirmed diagnosis of low and moderate CTS. The patients were randomly assigned to two groups. Group N was given 300 mg of PEA twice a day over 60 days and Group P received a placebo with exactly the same appearance every 12 h for the same period. CTS was evaluated before and after treatment through clinical findings, Boston Carpal Tunnel Questionnaire, visual analog scale (VAS) and electrophysiological data. The results were evaluated with Student's t test and chi-squared test.
  
  
  RESULTS
  No differences were observed in either group compared to the initial status regarding Durkan's test, Phalen's test, VAS and electrophysiological data after treatment. The Boston Questionnaire showed better results in both groups, with an improvement in only the symptom severity scale (SSS; p = 0.002809) for group P and improvement in the functional status scale (FSS; p = 0.03334) and SSS (p = 0.005) for group N.
  
  
  CONCLUSIONS
  The results of this study suggest that treatment of CTS with PEA at a dose of 600 mg/day is not associated with an improvement of any clinical and electrophysiological parameters. However, we observed an improvement in the FSS in the Boston Questionnaire after treatment with PEA. Together with the results of other studies, we conclude that further studies of PEA in CTS at higher doses are necessary.
  
  
  METHODS
  Level I of evidence according to 'The Oxford 2011 Level of Evidence'.
authors.affiliation: Hospital Sant Rafael, Pg. Vall d'Hebron 107-117, 08035, Barcelona, Catalonia, Spain. jfaigm.hsrafael@hospitalarias.es.
authors.forename: Jordi
authors.identifier: http://orcid.org/0000-0001-6141-7764
authors.initials: J
authors.lastname: Faig-Martí
authors.affiliation: Hospital Sant Rafael, Pg. Vall d'Hebron 107-117, 08035, Barcelona, Catalonia, Spain.
authors.forename: Adriana
authors.initials: A
authors.lastname: Martínez-Catassús
mesh_terms: D000328:Adult; D000577:Amides; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D004311:Double-Blind Method; D004983:Ethanolamines / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010169:Palmitic Acids / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D000577:Amides; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004983:Ethanolamines; D010169:Palmitic Acids; C005958:palmidrol
keywords: Carpal tunnel syndrome; Palmitoylethanolamide; Randomized control trial