Prednisolone in Complex Regional Pain Syndrome

Background: Although there are several studies of systemic corticosteroid therapies in variousdoses and various durations in complex regional pain syndrome (CRPS), the outcome measurementparameters are limited to the range of motion measurements, edema, and symptoms of CRPS.Objective: To investigate the effects of prednisolone on clinical symptoms, pain, hand gripstrength, range of motion, as well as on functional ability and quality of life in patients whodeveloped CRPS after traumatic upper extremity injury.Study Design: Retrospective evaluation.Methods: Forty-five patients who used prednisolone for CRPS of the upper extremity wereretrospectively studied. Prednisolone was started with a dose of 30 mg and tapered by 5 mg every3 days until discontinuation after 3 weeks. Clinical symptoms (morning stiffness, cold intolerance,shoulder pain, numbness of fingers, hyperesthesia, abnormal sweating, and cyanosis that isexacerbated by exposure to cold temperature), pain (Visual Analogue Scale-Rest [VAS-R] and VASActivity [VAS-A]) were reviewed. The muscle strength with grip strength (GS) (kg), lateral pinch(LP) (pound), tip-to-tip pinch (TP) (pound), and chuck pinch (CP) (pound) measurements; the jointrange of motion with using third finger tip-distal crease distance (FT-DC) (cm); functional abilitywith Quick-Disabilities of the Arm, Shoulder and Hand (Q-DASH) score; and quality of life withShort Form-36 (SF-36) score were evaluated.Results: Mean age was 43.53 ± 11.43 years. After 3 weeks of therapy, patients showed significantimprovements in clinical symptoms compared to the basal assessments (P < 0.05). The comparisonof pre- and post-treatment results revealed that VAS-R, VAS-A, GS, LP, TP, CP, FT-DC, Q-DASHscores, and all SF-36 subscores were significantly improved (P < 0.05).Limitations: The retrospective design and data collection procedure was limited to the medicalrecords of patients.Conclusion: A short-term oral prednisolone therapy significantly reduced the symptoms andsigns of CRPS, and improved the functional abilities and quality of life.Key words: Complex regional pain syndrome, prednisolone, function, quality of life