{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:14:52Z","timestamp":1778652892817,"version":"3.51.4"},"reference-count":40,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T00:00:00Z","timestamp":1702857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: In the Western world, back pain and sciatica are among the main causes of disability and absence from work with significant personal, social, and economic costs. This prospective observational study aims to evaluate the effectiveness of a rehabilitation program combined with the administration of Alpha Lipoic Acid, Acetyl-L-Carnitine, Resveratrol, and Cholecalciferol in the treatment of sciatica due to herniated discs in young patients in terms of pain resolution, postural alterations, taking painkillers, and quality of life. Materials and Methods: A prospective observational study was conducted on 128 patients with sciatica. We divided the sample into 3 groups: the Combo group, which received a combination of rehabilitation protocol and daily therapy with 600 mg Alpha Lipoic Acid, 1000 mg Acetyl-L-Carnitine, 50 mg Resveratrol, and 800 UI Cholecalciferol for 30 days; the Reha group, which received only a rehabilitation protocol; and the Supplement group, which received only oral supplementation with 600 mg Alpha Lipoic Acid, 1000 mg Acetyl-L-Carnitine, 50 mg Resveratrol, and 800 UI Cholecalciferol. Clinical assessments were made at the time of recruitment (T0), 30 days after the start of treatment (T1), and 60 days after the end of treatment (T2). The rating scales were as follows: the Numeric Rating Scale (NRS); the Oswestry Disability Questionnaire (ODQ); and the 36-item Short Form Health Survey (SF-36). All patients also underwent an instrumental stabilometric evaluation. Results: At T1, the Combo group showed statistically superior results compared to the other groups for pain (p &lt; 0.05), disability (p &lt; 0.05), and quality of life (p &lt; 0.05). At T2, the Combo group showed statistically superior results compared to the other groups only for pain (p &lt; 0.05) and quality of life (p &lt; 0.05). From the analysis of the stabilometric evaluation data, we only observed a statistically significant improvement at T2 in the Combo group for the average X (p &lt; 0.05) compared to the other groups. Conclusions: The combined treatment of rehabilitation and supplements with anti-inflammatory, pain-relieving, and antioxidant action is effective in the treatment of sciatica and can be useful in improving postural stability.<\/jats:p>","DOI":"10.3390\/medicina59122197","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T10:04:47Z","timestamp":1702893887000},"page":"2197","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Combined Rehabilitation with Alpha Lipoic Acid, Acetyl-L-Carnitine, Resveratrol, and Cholecalciferolin Discogenic Sciatica in Young People: A Randomized Clinical Trial"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5035-2288","authenticated-orcid":false,"given":"Dalila","family":"Scaturro","sequence":"first","affiliation":[{"name":"Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90144 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1630-1575","authenticated-orcid":false,"given":"Fabio","family":"Vitagliani","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Tomasello","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Surgery, University of Palermo, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5345-9902","authenticated-orcid":false,"given":"Cristiano","family":"Sconza","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Humanitas Clinical and Research Centre IRCSS, 20019 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Respizzi","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Humanitas Clinical and Research Centre IRCSS, 20019 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Letizia Mauro","sequence":"additional","affiliation":[{"name":"Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90144 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s11916-019-0757-1","article-title":"Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment","volume":"23","author":"Urits","year":"2019","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.wneu.2022.11.029","article-title":"Prevalence of Long-Term Low Back Pain after Symptomatic Lumbar Disc Herniation","volume":"170","author":"Wong","year":"2023","journal-title":"World Neurosurg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1002\/ajim.23444","article-title":"Psychosocial risk factors for low back pain in US workers: Data from the 2002\u20132018 quality of work life survey","volume":"66","author":"Yang","year":"2023","journal-title":"Am. J. Ind. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2791","DOI":"10.1007\/s00586-018-5673-2","article-title":"Clinical practice guidelines for the management of non-specific low back pain in primary care: An updated overview","volume":"27","author":"Oliveira","year":"2018","journal-title":"Eur. Spine J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"514","DOI":"10.7326\/M16-2367","article-title":"Clinical Guidelines Committee of the American College of Physicians Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jos.2021.10.006","article-title":"Efficacy of whole-body cryotherapy in the treatment of chronic low back pain: Quasi-experimental study","volume":"28","year":"2023","journal-title":"J. Orthop. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e051073","DOI":"10.1136\/bmjopen-2021-051073","article-title":"Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: A systematic review and meta-analysis of 381 studies (the meta-TENS study)","volume":"12","author":"Johnson","year":"2022","journal-title":"BMJ Open"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1136\/acupmed-2015-011036","article-title":"Low-Level Laser Therapy for Chronic Non-Specific Low Back Pain: A Meta-Analysis of Randomised Controlled Trials","volume":"34","author":"Glazov","year":"2016","journal-title":"Acupunct. Med."},{"key":"ref_10","first-page":"5670303","article-title":"Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis","volume":"2022","author":"Wang","year":"2022","journal-title":"Comput. Math. Methods Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s40122-019-00140-9","article-title":"Combination of Rehabilitative Therapy with Ultramicronized Palmitoylethanolamide for Chronic Low Back Pain: An Observational Study","volume":"9","author":"Scaturro","year":"2020","journal-title":"Pain Ther."},{"key":"ref_12","first-page":"2766","article-title":"Peripheral neuropathy in obstetrics: Efficacy and safety of \u03b1-lipoic acid supplementation","volume":"18","author":"Costantino","year":"2014","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"105874","DOI":"10.1016\/j.phrs.2021.105874","article-title":"Acetyl-L-carnitine in chronic pain: A narrative review","volume":"173","author":"Giorgi","year":"2021","journal-title":"Pharmacol. Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Genovese, T., Impellizzeri, D., D\u2019amico, R., Cordaro, M., Peritore, A.F., Crupi, R., Gugliandolo, E., Cuzzocrea, S., Fusco, R., and Siracusa, R. (2022). Resveratrol Inhibition of the WNT\/\u03b2-Catenin Pathway following Discogenic Low Back Pain. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23084092"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"611","DOI":"10.36076\/ppj\/2017.7.611","article-title":"Mapping the Association between Vitamin D and Low Back Pain: A Systematic Review and Meta-Analysis of Observational Studies","volume":"20","author":"Zadro","year":"2017","journal-title":"Pain Physician"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1007\/s00420-022-01949-2","article-title":"The association between cold exposure and musculoskeletal disorders: A prospective population-based study","volume":"96","author":"Lewis","year":"2023","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S158","DOI":"10.1002\/acr.20542","article-title":"Measures of function in low back pain\/disorders: Low Back Pain Rating Scale (LBPRS), Oswestry Disability Index (ODI), Progressive Isoinertial Lifting Evaluation (PILE), Quebec Back Pain Disability Scale (QBPDS), and Roland-Morris Disability Questionnaire (RDQ)","volume":"63","author":"Smeets","year":"2011","journal-title":"Arthritis Care Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1007\/s11999-014-3803-7","article-title":"What Are Long-term Predictors of Outcomes for Lumbar Disc Herniation? A Randomized and Observational Study","volume":"473","author":"Kerr","year":"2015","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Scaturro, D., Rizzo, S., Sanfilippo, V., Giustino, V., Messina, G., Martines, F., Falco, V., Cuntrera, D., Moretti, A., and Iolascon, G. (2021). Effectiveness of Rehabilitative Intervention on Pain, Postural Balance, and Quality of Life in Women with Multiple Vertebral Fragility Fractures: A Prospective Cohort Study. J. Funct. Morphol. Kinesiol., 6.","DOI":"10.3390\/jfmk6010024"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"105966","DOI":"10.1016\/j.clineuro.2020.105966","article-title":"Minimum clinically important difference of major patient-reported outcome measures in patients undergoing decompression surgery for lumbar spinal stenosis","volume":"196","author":"Ogura","year":"2020","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"478","DOI":"10.7326\/0003-4819-147-7-200710020-00006","article-title":"Clinical Efficacy Assessment Subcommittee of the American College of Physicians and the American College of Physicians\/American Pain Society Low Back Pain Guidelines Panel* Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society","volume":"147","author":"Chou","year":"2007","journal-title":"Ann. Intern. Med."},{"key":"ref_22","unstructured":"National Institute for Health and Care Excellence (2020). Neuropathic Pain in Adults: Pharmacological Management in Non-Specialist Settings, National Institute for Health and Care Excellence (NICE)."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.mayocp.2015.05.004","article-title":"Peripheral Neuropathy: A Practical Approach to Diagnosis and Symptom Management","volume":"90","author":"Watson","year":"2015","journal-title":"Mayo Clin. Proc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.intimp.2016.02.033","article-title":"Resveratrol attenuates neuropathic pain through balancing pro-inflammatory and anti-inflammatory cytokines release in mice","volume":"34","author":"Tao","year":"2016","journal-title":"Int. Immunopharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.neuint.2016.12.006","article-title":"The protective effect of resveratrol in the transmission of neuropathic pain mediated by the P2X7 receptor in the dorsal root ganglia","volume":"103","author":"Xie","year":"2017","journal-title":"Neurochem. Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1177\/03946320090220S309","article-title":"The Use and Alpha-Lipoic Acid (ALA), Gamma Linolenic Acid (GLA) and Rehabilitation in the Treatment of Back Pain: Effect on Health-Related Quality of Life","volume":"22","author":"Ranieri","year":"2009","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"495","DOI":"10.2165\/00044011-200828080-00004","article-title":"Thioctic Acid and Acetyl-L-Carnitine in the Treatment of Sciatic Pain Caused by a Herniated Disc: A randomized, double-blind, comparative study","volume":"28","author":"Memeo","year":"2008","journal-title":"Clin. Drug Investig."},{"key":"ref_28","first-page":"1653","article-title":"Management of Peripheral Neuropathies Study Group Observational multicentric study on chronic sciatic pain: Clinical data from 44 Italian centers","volume":"21","author":"Checchia","year":"2017","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Scaturro, D., Vitagliani, F., Di Bella, V.E., Falco, V., Tomasello, S., Lauricella, L., and Mauro, G.L. (2022). The Role of Acetyl-Carnitine and Rehabilitation in the Management of Patients with Post-COVID Syndrome: Case-Control Study. Appl. Sci., 12.","DOI":"10.3390\/app12084084"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.bbr.2008.12.038","article-title":"Oral supplementation with melon superoxide dismutase extract promotes antioxidant defences in the brain and prevents stress-induced impairment of spatial memory","volume":"200","author":"Nakajima","year":"2009","journal-title":"Behav. Brain Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s00011-006-5195-y","article-title":"Therapeutic potential of superoxide dismutase (SOD) for resolution of inflammation","volume":"55","author":"Yasui","year":"2006","journal-title":"Inflamm. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2165\/11599200-000000000-00000","article-title":"Combination of Alpha Lipoic Acid and Superoxide Dismutase Leads to Physiological and Symptomatic Improvements in Diabetic Neuropathy","volume":"12","author":"Bertolotto","year":"2012","journal-title":"Drugs R&D"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40268-013-0035-3","article-title":"\u03b1-Lipoic Acid and Superoxide Dismutase in the Management of Chronic Neck Pain: A Prospective Randomized Study","volume":"14","author":"Mauro","year":"2014","journal-title":"Drugs R&D"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"g6380","DOI":"10.1136\/bmj.g6380","article-title":"Opioids for low back pain","volume":"350","author":"Deyo","year":"2015","journal-title":"BMJ"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"7928","DOI":"10.1038\/s41598-023-34692-w","article-title":"The effect of chronic low back pain on postural control during quiet standing: A meta-analysis","volume":"13","author":"Park","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1054\/math.2002.0476","article-title":"Neuromuscular control of walking with chronic low-back pain","volume":"8","author":"Vogt","year":"2003","journal-title":"Man. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1007\/s00586-008-0709-7","article-title":"Persons with recurrent low back pain exhibit a rigid postural control strategy","volume":"17","author":"Brumagne","year":"2008","journal-title":"Eur. Spine J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1590\/S1413-78522012000400003","article-title":"Comparison of static postural balance between healthy subjects and those with low back pain","volume":"20","author":"Braga","year":"2012","journal-title":"Acta Ortop. Bras."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.neulet.2004.05.013","article-title":"Proprioceptive weighting changes in persons with low back pain and elderly persons during upright standing","volume":"366","author":"Brumagne","year":"2004","journal-title":"Neurosci. Lett."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"457","DOI":"10.5007\/1980-0037.2010v12n6p457","article-title":"Lombalgia e o equil\u00edbrio corporal de atletas da sele\u00e7\u00e3o brasileira feminina de canoagem velocidade","volume":"12","author":"Lemos","year":"2010","journal-title":"Rev. Bras. Cineantropom Desempenho."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/12\/2197\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:41:00Z","timestamp":1760132460000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/12\/2197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,18]]},"references-count":40,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["medicina59122197"],"URL":"https:\/\/doi.org\/10.3390\/medicina59122197","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,18]]}}}