Both ALCAR (Acetyl-L-Carnitine) and ALA (Alpha-Lipoic Acid) improve sciatica (nerve pain down the leg)

October 19, 2011
Sciatica is a very painful condition. The major nerve that travels down the leg becomes inflamed. Pain can be debilitating. This is often caused by a herniated disc in the lumbar or sacral spine. Acetyl-L-Carnitine (ALCAR) is a naturally occurring substance that promotes regeneration of nerve tissue and it has analgesic effects in patients with peripheral neuropathies related to diabetes, HIV, or chemotherapy. Alpha-Lipoic-Acid (ALA) is a key antioxidant in the body that may help the recovery of nerve functional and many studies show it decreases neuropathic (nerve) pain. This study aimed to compare, for the first time, the efficacy of oral treatment with ALCAR or ALA in patients with peripheral neuropathy; in these patients it was sciatic pain caused by a herniated disc.

This was a randomized, double-blind trial conducted in a hospital setting. A total of 64 consecutive patients with acute backache and moderate sciatica were recruited. The 33 patients in group 1 received 1180 mg of ALCAR daily for two months and the 31 patients in group 2 received 600 mg of ALA daily for the same period. The researchers measured changes in clinical signs and symptoms as measured on the Neuropathy Impairment Score in the Lower Limbs (NIS-LL) questionnaire, the Neuropathy Symptoms and Change in the Lower Limbs (NSC-LL) questionnaire, and the Total Symptom Score (TSS) questionnaire. The next level of improvement was how successful were the supplements in improving neurological deficit as measured by electromyography to gauge improvement in nerve function compared with the start of the study.

Both treatments produced significant improvements from baseline in nerve pain on electromyography at day 60. ALA worked slightly better than ALCAR although the between-group difference was slight and not statistically significant. 71% of patients receiving ALA reported a decreased need for pain killers while 45.5% of those on ALCAR reported a decreased need for pain killers. The study is published in the journal Clinical Drug Investigation, 2008;28(8):495-500.