Effectiveness of prednisolone in complex regional pain syndrome treatment: A systematic narrative review.
Abstract
Background: Many patients with complex regional pain syndrome (CRPS) experience refractory pain with severe restrictions in the activities of daily living. Oral prednisolone is commonly used to treat these patients.
Purpose: To review previous studies assessing the effects of prednisolone in CRPS patients.
Methods and materials: Articles published from January 1, 1980 to July 23, 2021 in the PubMed database were searched using the following key phrases: (prednisolone OR corticosteroid OR steroid) AND (complex regional pain syndrome OR reflex sympathetic dystrophy OR shoulder-hand syndrome OR causalgia). Specifically, we included those articles in which oral prednisolone or corticosteroids were used to control the CRPS symptoms.
Results: In total, 11 articles were included, comprising 3 randomized trials, 5?single-arm prospective observational studies, and 3 retrospective studies. Nearly all previous studies reported that oral prednisolone can effectively control the CRPS symptoms. Moreover, though 30-100?mg/day of oral prednisolone was initially administered in these studies, 30?mg/day was also found to be effective in controlling the symptoms. Although prednisolone was usually administered for 1-3?months, short-term treatment for 1-2?weeks was also reportedly effective. Furthermore, only 0%-30% of the patients in these studies had minor side effects after prednisolone treatment.
Conclusions: Our review showed that prednisolone may be effective in alleviating the CRPS symptoms. To determine higher levels of evidence, a full systematic review with more highly qualified studies, such as randomized controlled trials, should be conducted in the future.