Abstract
Objective The objective of this study was to evaluate prednisone effectiveness on complex regional pain syndrome (CRPS) features in a community-based outpatient rehabilitation setting. Design A single-centre, retrospective inception cohort design was used. Inclusion criteria were CRPS diagnosis according to the Budapest criteria, involvement of multiple joints, treatment with prednisone, and duration of symptoms less than one year. Typical prednisone treatment was 28-day taper regimen with 60 mg. Patient symptoms and signs were compared before and after treatment. Results There were 39 patients who met inclusion criteria for analysis. Duration of symptoms before treatment was 80.8 ± 67.7 days. Following treatment, 19 (48.7%) patients reported complete pain resolution, 19 (48.7%) patients reported decreased pain permitting functional use, and 1 (2.6%) patient reported no improvement. All symptoms and signs decreased significantly following oral prednisone treatment (p < 0.001). Range of motion (ROM) deficits persisted in 19 (49%) patients. However, 17 of these patients reported functional ROM recovery. Degree of ROM recovery and time-to-treatment had low positive correlation (r = 0.354, p < 0.001). Range of motion (ROM) deficits persisted in 19 (49%) patients. However, 17 of these patients reported functional ROM recovery. Degree of ROM recovery and time-to-treatment had low positive correlation (Conclusions These data support short-course prednisone treatment for acute and subacute CRPS with multijoint involvement in a community rehabilitation setting. The association between time-to-treatment and ROM recovery suggests earlier treatment may result in improved ROM outcomes.
Highlights
Complex regional pain syndrome (CRPS) is defined as a group of regionally painful conditions disproportionate to any inciting event [1]
To ensure all cases were captured from our electronic medical record, a search for the ICD code for CRPS was performed for all cases between May 2013 and May 2018. is study was approved by the local ethics review board
59.0% of patients completed the 60 mg prednisone taper, 33.4% completed prednisone taper starting from a lower initial dose, and 7.7% of patients completed the 60 mg prednisone taper with an additional two weeks of 20 mg prednisone taper due Budapest criteria signs and symptoms (IASP [1])
Summary
Prednisone for Acute Complex Regional Pain Syndrome: A Retrospective Cohort Study. E objective of this study was to evaluate prednisone effectiveness on complex regional pain syndrome (CRPS) features in a community-based outpatient rehabilitation setting. Inclusion criteria were CRPS diagnosis according to the Budapest criteria, involvement of multiple joints, treatment with prednisone, and duration of symptoms less than one year. Patient symptoms and signs were compared before and after treatment. All symptoms and signs decreased significantly following oral prednisone treatment (p < 0.001). 17 of these patients reported functional ROM recovery. Ese data support short-course prednisone treatment for acute and subacute CRPS with multijoint involvement in a community rehabilitation setting. E association between time-totreatment and ROM recovery suggests earlier treatment may result in improved ROM outcomes Conclusions. ese data support short-course prednisone treatment for acute and subacute CRPS with multijoint involvement in a community rehabilitation setting. e association between time-totreatment and ROM recovery suggests earlier treatment may result in improved ROM outcomes
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