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Doctor, I have Carpal Tunnel Syndrome. Can Pregabalin improve my symptoms?

For some people with mild to moderate carpal tunnel syndrome, treatment with Pregabalin may reduce symptoms.

What is the evidence?

SUMMARY OF FINDINGS

Pregabalin versus Placebo

OutcomeTreatmentBaselineAt 8 weeksEffect
Symptom Severity Score*

Pregabalin

Placebo

20.8

20.4

14.9

16.6

People who took Pregabalin had fewer symptoms at 8 weeks than people who took placebo
Functional Status Score**

Pregabalin

Placebo

13.3

13.8

10.8

12.0

People who took Pregabalin had better function at 8 weeks than people who took placebo

* higher score means more symptoms; **higher score means greater difficulty with using their hand


What kind of study was this?

This was a randomized controlled trial (RCT).

Who? This study included 146 adults (average age 40 years; 68% female) with mild to moderate carpal tunnel syndrome for an average of 7 months. Most people had carpal tunnel syndrome in their right wrist and 27% had involvement of both wrists. People who had a known cause for their carpal tunnel syndrome such as diabetes, rheumatoid arthritis or a fracture of one of the bones in the wrist were excluded.

What? The study compared Pregabalin with placebo.

Pregabalin

vs

Placebo

Pregabalin 50 mg capsule taken by mouth once a day for the 1st week, two times a day for the 2nd week, and 3 times a day for the 3rd to 8th week.

Also allowed to take pain medications and use a carpal tunnel splint at night


Placebo: A pill/needle/lotion containing an inactive substance that has no effect on the outcome. Sometimes, it is referred to as a "sugar pill. The placebo capsules were taken following the same instructions as for the Pregabalin group.

Also allowed to take pain medications and use a carpal tunnel splint at night


Why was this research done?

Carpal tunnel syndrome is generally caused by a nerve in the wrist (median nerve) that becomes trapped. This syndrome causes pain, tingling, and poor function of the hand. A variety of medications have been tried to treat carpel tunnel syndrome, and in severe cases, surgery may be performed. The researchers wanted to know if Pregabalin, a medication used to treat other types of nerve-related (neuropathic) pain, would reduce symptoms for people with mild to moderate carpel tunnel syndrome. They found that Pregabalin reduced pain and improved function for some people at 8 weeks, but with more side effects (i.e., mostly temporary sleepiness, fatigue, dizziness). Concerns about this study include that it was only done at a single centre with a small number of people, and that it only analyzed the results from participants who were very good at following study instructions. A larger study is needed to confirm the results.

This Evidence Summary is based on the following article:

Bismaya K, Singh VK, Pathak A, et al. Evaluating the Effect of Pregabalin in the Treatment of Carpal Tunnel Syndrome: A Prospective, Randomized, Triple-Blinded, Placebo-controlled Trial. Clin J Pain. 2023 Nov 1;39(11):604-610. doi: 10.1097/AJP.0000000000001154. PubMed

Published: Wednesday, November 15, 2023

Please note that the information contained herein is not to be interpreted as an alternative to medical advice from a professional healthcare provider. If you have any questions about any medical matter, you should consult your professional healthcare providers, and should never delay seeking medical advice, disregard medical advice or discontinue medication based on information provided here.

This Evidence Summary was printed from the PAIN+ CPN website on 2024/07/14.

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