Complex regional pain syndrome
(CRPS), previously known as reflex sympathetic dystrophy, is a chronic pain condition characterized by intense pain that is disproportionate to the initial injury that caused it. Other symptoms experienced by CRPS patients in the affected area include burning discomfort, changes in temperature and skin color, and extreme sensitivity to touch. CRPS may worsen over time and may spread to other parts of the body. Treatments aim to relieve painful symptoms, but no cure exists.
A previous study found that
reduced the risk of CRPS in people with wrist fractures. In a study published in the July 2007
Journal of Bone & Joint Surgery
, researchers set out to confirm those findings, and to determine the most effective vitamin C dose for CRPS prevention. They found that a daily dose of 500 milligrams of vitamin C taken for 50 days significantly reduced the risk of CRPS in people with fractured wrists, compared to placebo.
About the Study
The researchers recruited 416 men and women who had fractured their wrists. The study subjects were treated with plaster casts or surgery, at their doctors’ discretion. Three hundred seventeen of the patients took 200 milligrams (mg), 500 mg, or 1,500 mg of vitamin C every day for 50 days beginning on the day of their wrist fracture. The remaining 99 study subjects took a placebo for the same period of time. The patients were followed for one year. The researchers noted all cases of CRPS that were diagnosed during this time.
In the vitamin C group, 2.4% developed CRPS during the study, compared to 10.1% of the placebo group. This was a significant difference. These results remained true even after the researchers considered the type of fracture and whether patients were treated with casts or surgery. When the results were broken down by dose, only patients taking 500 mg or 1,500 mg of vitamin C per day had a significantly reduced risk of CRPS compared to placebo. There was no significant difference in CRPS risk between the 500 mg and 1,500 mg groups.
All of the patients who developed CRPS in this study were women, and the condition occurred significantly more frequently in older patients. In addition, patients who had complaints relating to their casts were significantly more likely to develop CRPS.
How Does This Affect You?
This study found that vitamin C may help protect against CRPS in people with wrist fractures. Based on the findings, it appears that 500 mg, taken daily for 50 days may be an appropriate dose.
CRPS is a chronic, painful condition. Its cause is not known, and there is no cure. As a result, prevention is the best treatment. Although it is difficult to predict who will develop CRPS, this study did provide a few clues. Most strikingly, all of the patients who developed CRPS in this study were women. CRPS patients were also older, and were more likely to have complaints relating to their casts before their CRPS diagnosis. If you have recently sustained fracture, it would probably be worthwhile to discuss vitamin C therapy with your physician, especially if you fall into one of these high risk groups for CRPS.
Last reviewed September 2007 by Richard Glickman-Simon, MD
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