The ACTS Trial: N-acetylcysteine (NAC) and Night-splinting as a Non-operative Treatment for Carpal Tunnel Syndrome
Status:
Recruiting
Trial end date:
2023-05-01
Target enrollment:
Participant gender:
Summary
Carpal tunnel syndrome (CTS) is the most common nerve compression syndrome worldwide, causing
significant chronic pain, functional impairment, and lowered quality of life for individuals
of various backgrounds. CTS is caused by chronic compression of the median nerve in the
carpal tunnel of the wrist, causing numbness and pain in the palm, thumb, index, and middle
fingers and eventual weakness of the hand. Many different treatments for CTS have been
proposed and studied, including but not limited to non-operative treatments such as wrist
splinting, steroid injections, and lifestyle modifications as well as operative treatments,
such as surgical carpal tunnel release (CTR). To date, very few oral medications have been
shown to be effective as conservative treatments for CTS. In this study the investigators
will examine whether there is any benefit to using oral N-acetylcysteine (NAC) as an
adjunctive treatment for mild to moderate CTS in addition to a standard 8-week trial of night
splinting. NAC has been used in humans for various purposes, is extremely safe and has very
few side effects, and has been shown to have anti-inflammation properties which may help
treat CTS. The investigators will study this by performing a randomized controlled trial,
comparing patients receiving oral NAC and standard night splinting to patients receiving an
identical placebo and standard night splinting. Both patient groups will be assessed using a
questionnaire to assess for severity of their CTS symptoms both before and after the 8-week
treatment. The primary objective will be to determine whether supplementation with oral NAC
in addition to night splinting has any significant impact on patient-reported symptoms and
functional impairment when compared to night splinting alone. The investigators will also
measure secondary outcomes including whether patients decide to have surgery for their CTS
after treatment and/or continued use of other treatments. This study has the potential to
have a significant positive impact on patients by identifying a safe, inexpensive,
accessible, and well tolerated conservative treatment for mild to moderate carpal tunnel
syndrome, and potentially preventing the need for additional, more invasive treatments such
as surgery.