Comparing the treatment of sciatica with Alpha-Lipoic Acid or Acetyl-L-Carnitine

     Sciatica is a very painful condition of a major nerve that travels down the leg that is usually caused by a herniated disc in the lumbar or sacral spine. Acetyl-L-Carnitine (ALCAR) is a naturally occurring substance that promotes peripheral nerve regeneration and has been shown to have analgesic effects in patients with peripheral neuropathies of diabetic, HIV-related or chemotherapeutic origin. Alpha-Lipoic-Acid (ALA) is a key antioxidant in the body that may help the recovery of nerve functionality and decrease neuropathic pain. This study aimed to compare, for the first time, the efficacy of oral treatment with ALCAR or ALA in patients with peripheral neuropathic (sciatic) pain associated with a herniated disc.

     This was a randomized, double-blind trial conducted in a hospital setting. A total of 64 consecutive patients (mean age 61 years; range 29-85) with acute backache and moderate sciatica were recruited. The 33 patients in group 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) compared with baseline.

     Both treatments produced significant improvements from baseline in neuropathy (nerve pain) on electromyography at day 60, and greater mean improvements were observed with ALA than with ALCAR although the between-group difference was 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 (p < 0.05). The study is published in the journal Clinical Drug Investigation, 2008;28(8):495-500. Commentary by Jerry Hickey, R.Ph.; research shows that combining the treatment of ALA with ALCAR may improve results dramatically. A recent study published in the Journal of Cellular and Molecular Medicine shows that combining ALCAR with ALA improves benefits for energy production, antioxidant activity, and cellular damage anywhere between 100-1000 fold lower concentrations than they did individually in a study of the effects on human brain cells and protection for Parkinson’s disease.
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