New candidates for treatment and management of carpal tunnel syndrome based on the Persian Canon of Medicine

다국어 초록 (Multilingual Abstract)

Carpal tunnel syndrome (CTS) is defined as a compressing median mononeuropathy. CTS is one of the major costly debilitating diseases of the hand. Although CTS is a relatively recent concept in current medicine, some evidences show that medieval physicians in Persian medicine (PM) such as Avicenna were familiar with it. The PM textbook written by Avicenna, the Canon of Medicine, defines the anatomy of carpal tunnel and median nerve, as well as mononeuropathy; it also offers suggestions for the prevention and treatment of carpal tunnel syndrome (called as Vaja al-asab and Khadar) in the chapter of nerve diseases. The book describes not only symptoms including pain, paresthesia, hypoesthesia, tingling, and numbness, but also its etiology such as nerve compression (entrapment neuropathy); nonphysical reasons such as disturbed balance among the four body humors; alteration in the nerve's temperament (Mizaj) that prevents the transmission of nerve impulses; and the others such as nutrition, mental condition, sleep, weather condition, body movements, and proper disposal of body waste. Furthermore, the book suggests a lifestyle modification method based on six factors and 10 prescriptions composed with 85 natural products that are not actively used for CTS treatment in modern times. The medicinal suggestions for CTS in the Canon of Medicine will be good candidates for discovering new treatments besides providing historical significance to the various insights considered 1000 years ago.

참고문헌 (Reference)

1 World Health Organization, "WHO traditional medicine strategy 2014–2023"

2 Shoja MM, "Vasovagal syncope in the Canon of Avicenna : the first mention of carotid artery hypersensitivity" 134 : 297-301, 2009

3 Ziglioli F, "Vanilloid-mediated apoptosis in prostate cancer cells through a TRPV-1 dependent and a TRPV-1-independent mechanism" 80 : 13-20, 2009

4 Heydari M, "Topical Citrullus colocynthis (bitter apple) extract oil in painful diabetic neuropathy: a double-blind randomized placebo-controlled clinical trial" 8 : 246-252, 2016

5 Heydari M, "The origin of the concept of neuropathic pain in Early Medieval Persia (9th–12th century CE)" 13 (13): 9-22, 2015

6 Atkin M, "The effects of garlic extract upon endothelial function, vascular inflammation, oxidative stress and insulin resistance in adults with type 2diabetes at high cardiovascular risk. A pilot double blind randomized placebo controlled trial" 30 : 723-727, 2016

7 Foley M, "The economic burden of carpal tunnel syndrome : long-term earnings of CTS claimants in Washington State" 50 : 155-172, 2007

8 Choopani R, "The concept of lifestyle factors, based on the teaching of Avicenna (Ibn Sina)" 6 : 30-37, 2015

9 Avicenna H, "The Canon of Medicine" Dar-Ehya-al-Torath-al-Arabi 2005

10 Alaniia M, "Study of antioxidant activity of phenolic compounds from some species of Georgian flora" 222 : 69-72, 2013

11 Wierzchowska-Renke K, "Studies of Asarum europaeum L. II. Preliminary studies of the content of volatile oil and l-ascorbic acid in Herba Asari cum radicibus obtained at the Gdansk coastal region" 27 : 63-69, 1970

12 Chen L, "Structural, thermal, and anti-inflammatory properties of a novel pectic polysaccharide from alfalfa (Medicago sativa L.) stem" 63 : 3219-3228, 2015

13 Scalco RS, "Seasonal variation in prevalence of carpal tunnel syndrome" 47 : 925-927, 2013

14 Mahboubi M, "Rosa damascena as holy ancient herb with novel applications" 6 : 10-16, 2016

15 Evanoff B, "Risk factors for incident carpal tunnel syndrome : results of a prospective cohort study of newly-hired workers" 41 : 4450-4452, 2012

16 Atroshi I, "Prevalence of carpal tunnel syndrome in a general population" 282 : 153-158, 2009

17 Dale AM, "Prevalence and incidence of carpal tunnel syndrome in US working populations : pooled analysis of six prospective studies" 39 : 495-505, 2013

18 Yun HM, "Potential therapeutic effects of functionally active compounds isolated from garlic" 142 : 183-195, 2014

19 Rajamurugan R, "Polyphenol contents and antioxidant activity of Brassica nigra (L.) Koch. leaf extract" 26 : 2208-2210, 2012

20 Chan EW, "Phytochemistry, pharmacology, and clinical trials of Morus alba" 14 : 17-30, 2016

21 Fitsiou E, "Phytochemical profile and evaluation of the biological activities of essential oils derived from the Greek aromatic plant species Ocimum basilicum, Mentha spicata, Pimpinella anisum and Fortunella margarita" 21 : 1069-, 2016

22 Resende LA, "Peripheral facial palsy in the past:contributions from Avicenna, Nicolaus Friedreich and Charles Bell" 66 : 765-769, 2008

23 Ratheesh M, "Methanolic extract of Ruta graveolens L. inhibits inflammation and oxidative stress in adjuvant induced model of arthritis in rats" 17 : 100-105, 2009

24 Zargaran A, "Management of tremor in medieval Persia" 22 : 53-61, 2013

25 Zargaran A, "Management of stroke as described by Ibn Sina(Avicenna)in the Canon of Medicine" 169 : 233-237, 2013

26 Balouchi A, "Knowledge, attitude and use of complementary and integrative health strategies: a preliminary survey of Iranian nurses" 14 : 121-127, 2016

27 Pearce JM, "John Fothergill:. a biographical sketch and his contributions to neurology" 22 : 261-276, 2013

28 Prime MS, "Is there light at the end of the tunnel? Controversies in the diagnosis and management of carpal tunnel syndrome" 5 : 354-360, 2010

29 Zyluk A, "Is carpal tunnel syndrome an occupational disease? A review" 78 : 121-126, 2013

30 Yasukawa K, "Inhibitory effect of the flowers of artichoke(Cynara cardunculus)on TPA-induced inflammation and tumor promotion in two-stage carcinogenesis in mouse skin" 64 : 388-391, 2010

31 Ahmad B, "Inhibition activities of Colchicum luteum baker on lipoxygenase and other enzymes" 21 : 449-452, 2006

32 Senol FS, "In vitro cholinesterase inhibitory and antioxidant effect of selected coniferous tree species" 8 : 269-275, 2015

33 Abokrysha N, "Ibn Sina (Avicenna) on pathogenesis of migraine compared with the recent theories" 49 : 923-927, 2009

34 Shiri R, "Hypothyroidism and carpal tunnel syndrome : a meta-analysis" 50 : 879-883, 2014

35 Loued S, "Extra-virgin olive oil consumption reduces the age-related decrease in HDL and paraoxonase 1anti-inflammatory activities" 110 : 1272-1284, 2013

36 Ginanneschi F, "Evidences for antinociceptive effect of 17-alpha-hydroxyprogesterone caproate in carpal tunnel syndrome" 47 : 59-66, 2012

37 Ismail H, "Evaluation of analgesic, anti-inflammatory, anti-depressant and anti-coagulant properties of Lactuca sativa (CV. Grand Rapids) plant tissues and cell suspension in rats" 15 : 199-, 2015

38 Nesa L, "Evaluation of analgesic, anti-inflammatory and CNS depressant activities of methanolic extract of Lawsonia inermis barks in mice" 4 : 287-296, 2014

39 Hashempur MH, "Efficacy of topical chamomile oil for mild and moderate carpal tunnel syndrome : a randomized double-blind placebo-controlled clinical trial" 26 : 61-67, 2017

40 Venturini D, "Effects of extra virgin olive oil and fish oil on lipid profile and oxidative stress in patients with metabolic syndrome" 31 : 834-840, 2015

41 Gupta SK, "Effects of Trigonella foenum-graecum (L.) on retinal oxidative stress, and proinflammatory and angiogenic molecular biomarkers in streptozotocin-induced diabetic rats" 388 : 1-9, 2014

42 Sarahroodi S, "Effects of Nepeta menthoides aqueous extract on retention and retrieval of memory in mice" 15 : 1085-1089, 2012

43 Reddy S, "Effects of Acorus calamus rhizome extract on the neuromodulatory system in restraint stress male rats" 25 : 425-431, 2015

44 Ballestero-Pérez R, "Effectiveness of nerve gliding exercises on carpal tunnel syndrome : a systematic review" 40 : 50-59, 2017

45 Yoo W-g, "Effect of the release exercise and exercise position in a patient with carpal tunnel syndrome" 27 : 3345-3346, 2015

46 Hashempur MH, "Effect of Linum usitatissimum L. (linseed) oil on mild and moderate carpal tunnel syndrome:a randomized, double-blind, placebo-controlled clinical trial" 22 : 43-52, 2014

47 Uchiyama S, "Current concepts of carpal tunnel syndrome:pathophysiology, treatment, and evaluation" 15 : 1-13, 2010

48 Lewis C, "Current concepts in carpal tunnel syndrome : a review of the literature" 20 : 445-452, 2010

49 Adhami HR, "Compounds from gum ammoniacum with acetylcholinesterase inhibitory activity" 81 : 793-805, 2013

50 Ellis J, "Clinical results of a cross-over treatment with pyridoxine and placebo of the carpal tunnel syndrome" 32 : 2040-2046, 1979

51 MacDermid JC, "Clinical and electrodiagnostic testing of carpal tunnel syndrome : a narrative review" 34 : 565-588,

52 De Krom MCTFM, "Carpal tunnel syndrome: prevalence in the general population" 45 : 373-376, 1992

53 Padua L, "Carpal tunnel syndrome: clinical features, diagnosis, and management" 15 : 1273-1284, 2016

54 Ibrahim I, "Carpal tunnel syndrome: a review of the recent literature" 6 : 69-76, 2012

55 Huisstede BM, "Carpal tunnel syndrome. Part I:effectiveness of nonsurgical treatments – a systematic review" 91 : 981-1004, 2010

56 Zyluk A, "Carpal tunnel syndrome in pregnancy : a review" 78 : 223-227, 2013

57 Karne SS, "Carpal tunnel syndrome in hypothyroidism" 10 : 36-38, 2016

58 Barcenilla A, "Carpal tunnel syndrome and its relationship to occupation : a meta-analysis" 51 : 250-261, 2012

59 Palmer KT, "Carpal tunnel syndrome : the role of occupational factors" 25 : 15-29, 2011

60 Wipperman J, "Carpal tunnel syndrome : diagnosis and management" 94 : 993-999, 2016

61 Aroori S, "Carpal tunnel syndrome" 77 : 6-17, 2008

62 Bland JDP, "Carpal tunnel syndrome" 335 : 343-346, 2007

63 Verma SK, "Blood pressure lowering, fibrinolysis enhancing and antioxidant activities of cardamom (Elettaria cardamomum)" 46 : 503-506, 2009

64 Zargaran A, "Avicenna (980–1037 AD)" 259 : 389-390, 2012

65 Flaherty G, "Attitudes of medical students toward the practice and teaching of integrative medicine" 13 : 412-415, 2015

66 Gebhardt R., "Antioxidative, antiproliferative and biochemical effects in HepG2 cells of a homeopathic remedy and its constituent plant tinctures tested separately or in combination" 53 : 823-830, 2003

67 Sadeghi L, "Antioxidant effects of alfalfa can improve iron oxide nanoparticle damage: in vivo and in vitro studies" 81 : 39-46, 2016

68 Fatrcova-Sramkova K, "Antioxidant and antimicrobial properties of monofloral bee pollen" 48 : 133-138, 2013

69 Bouterfas K, "Antioxidant activity and total phenolic and flavonoids content variations of leaves extracts of white Horehound(Marrubium vulgare Linne)from three geographical origins" 74 : 453-462, 2016

70 Noroozi S, "Antigenotoxic effects of the disulfide compound persicasulfide A(PSA)on rat lymphocytes exposed to oxidative stress" 75 : 32-36, 2009

71 Selim S, "Anti-inflammatory, antioxidant and antiangiogenic activities of diosgenin isolated from traditional medicinal plant, Costus speciosus (Koen ex. Retz.)Sm" 30 : 1830-1833, 2016

72 Ivanova D, "Agrimonia eupatoria tea consumption in relation to markers of inflammation, oxidative status and lipid metabolism in healthy subjects" 119 : 32-37, 2013

73 Saito N, "Acylated anthocyanins from the blue-violet flowers of Anemone coronaria" 60 : 365-373, 2002

74 Boskovski MT, "Acroparesthesia and carpal tunnel syndrome : a historical perspective" 39 : 1813-1821, 2014

75 Setayesh M, "A topical gel from flax seed oil compared with hand splint in carpal tunnel syndrome : a randomized clinical trial" 22 : 462-467, 2017

76 Jackson WA, "A short guide to humoral medicine" 22 : 487-489, 2001

77 Zargaran A, "A review on the management of migraine in the Avicenna’s Canon of Medicine" 37 : 471-478, 2016

78 Hashempur MH, "A pilot randomized double-blind placebo-controlled trial on topical chamomile (Matricaria chamomilla L.) oil for severe carpal tunnel syndrome" 21 : 223-228, 2015