Background: Although there are several studies of systemic corticosteroid therapies in various
doses and various durations in complex regional pain syndrome (CRPS), the outcome measurement
parameters 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 grip
strength, range of motion, as well as on functional ability and quality of life in patients who
developed CRPS after traumatic upper extremity injury.
Study Design: Retrospective evaluation.
Methods: Forty-five patients who used prednisolone for CRPS of the upper extremity were
retrospectively studied. Prednisolone was started with a dose of 30 mg and tapered by 5 mg every
3 days until discontinuation after 3 weeks. Clinical symptoms (morning stiffness, cold intolerance,
shoulder pain, numbness of fingers, hyperesthesia, abnormal sweating, and cyanosis that is
exacerbated 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 joint
range of motion with using third finger tip-distal crease distance (FT-DC) (cm); functional ability
with Quick-Disabilities of the Arm, Shoulder and Hand (Q-DASH) score; and quality of life with
Short Form-36 (SF-36) score were evaluated.
Results: Mean age was 43.53 ± 11.43 years. After 3 weeks of therapy, patients showed significant
improvements in clinical symptoms compared to the basal assessments (P < 0.05). The comparison
of pre- and post-treatment results revealed that VAS-R, VAS-A, GS, LP, TP, CP, FT-DC, Q-DASH
scores, and all SF-36 subscores were significantly improved (P < 0.05).
Limitations: The retrospective design and data collection procedure was limited to the medical
records of patients.
Conclusion: A short-term oral prednisolone therapy significantly reduced the symptoms and
signs of CRPS, and improved the functional abilities and quality of life.
Key words: Complex regional pain syndrome, prednisolone, function, quality of life