Steroids – prednisone, methylprednisolone (Medrol ®)
Steroids were used very early on in adults. In a small study they were found to be helpful. However, they had no appreciable effect in a small study of children with complex regional pain syndrome (CRPS). One investigator injected steroids intrathecally (into the spinal fluid), but the study was stopped due to side effects and lack of efficacy. Steroids have a host of significant side effects and are not recommended.
Side effects include (side effects increase with duration of treatment):
- Increased appetite
- Weight gain
- Suppressed immune system
- Osteoporosis
- Increased hair growth
- Acne
- Stretch marks
- Avascular necrosis of the bone
- High blood pressure
- Diabetes
- Growth retardation
- Psychosis
- Christensen K, Jensen EM, Noer I. The reflex dystrophy syndrome response to treatment with systemic corticosteroids. Acta Chirurgica Scandinavica 1982;148:653-5.
- Ruggeri SB, Athreya BH, Doughty R, Gregg JR, Das MM. Reflex sympathetic dystrophy in children. Clin Orthop Relat Res 1982; 163:225-30.
- Munts AG, van der Plas AA, Ferrari MD, Teepe-Twiss IM, Marinus J, van Hilten JJ. Efficacy and safety of a single intrathecal methylprednisolone bolus in chronic complex regional pain syndrome. European journal of pain (London, England) 2010;14:523-8.