What is the role of corticosteroids in the treatment of complex regional pain syndrome (CRPS)?

Updated: Jun 20, 2018
  • Author: Gaurav Gupta, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Pulsed doses of steroids (60-80 mg/d for 2 wk) have been reported as beneficial for CRPS in a small, uncontrolled case series. [78] Two small, single blind trials of 10 and 17 patients with early-stage CRPS (within 2-3 mo of injury) also reported clinical improvement after 4 or 12 weeks of oral corticosteroid therapy. [79, 80] No long-term follow-up data were reported in any of these studies.

Clinical experience has shown that the use of corticosteroids in patients with CRPS who have had symptoms for more than 6 months has little efficacy. Also, many patients report the return of their pain and other symptoms after the corticosteroid dose was tapered. However, some experts recommend the use of corticosteroids, especially in the early stages of CRPS. One study demonstrated that orally administered prednisone, 10 mg tid., was effective in improving the entire clinical status (up to 75%) of acute CRPS (< 13 wk). [79] No evidence has been obtained with regard to the efficacy of other immunomodulating therapies in treating CRPS. [59]


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