M Schürmann1, T Vogel, A Gärtner, H J Andress, G Gradl. 1. Unfallchirurgie, Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München im Klinikum Grosshadern. mschuerm@gch.med.uni-muenchen.de
Abstract
UNLABELLED: PURPOSE/METHODS/PATIENTS: Calcitonin is a common treatment in patients suffering from Complex Regional Pain Syndrome Type 1 (CRPS I), although its effects are being controversially discussed. In a prospective study of 24 patients with CRPS I of the upper limb, we examined the tolerance of daily doses of 0.5 mg human calcitonin administered subcutaneously over 8 weeks. To assess the benefit of this therapy, the patients were clinically examined every second week. The results were compared to a consecutive group of 25 CRPS 1 patients who received only analgetics and physiotherapy. RESULTS: With regard to all examined parameters (spontaneous pain, grip strength, edema, hand function, systematic temperature difference), the patients treated with calcitonin showed an improvement during the observation time. However, a statistically significant difference to the control group was calculated only for the reduction of the edema (P < 0.01). 83% (20/24 patients) of the calcitonin-treated patients suffered from severe, mostly gastroenterological side-effects. Hence therapy had to be discontinued in 3 cases (13%). CONCLUSION: The therapy with calcitonin has the burden of numerous unpleasant side-effects and causes only a slight therapeutic improvement. Thus, calcitonin must only be prescribed with reservations for patients suffering from CRPS I.
UNLABELLED: PURPOSE/METHODS/PATIENTS: Calcitonin is a common treatment in patients suffering from Complex Regional Pain Syndrome Type 1 (CRPS I), although its effects are being controversially discussed. In a prospective study of 24 patients with CRPS I of the upper limb, we examined the tolerance of daily doses of 0.5 mg humancalcitonin administered subcutaneously over 8 weeks. To assess the benefit of this therapy, the patients were clinically examined every second week. The results were compared to a consecutive group of 25 CRPS 1 patients who received only analgetics and physiotherapy. RESULTS: With regard to all examined parameters (spontaneous pain, grip strength, edema, hand function, systematic temperature difference), the patients treated with calcitonin showed an improvement during the observation time. However, a statistically significant difference to the control group was calculated only for the reduction of the edema (P < 0.01). 83% (20/24 patients) of the calcitonin-treated patients suffered from severe, mostly gastroenterological side-effects. Hence therapy had to be discontinued in 3 cases (13%). CONCLUSION: The therapy with calcitonin has the burden of numerous unpleasant side-effects and causes only a slight therapeutic improvement. Thus, calcitonin must only be prescribed with reservations for patients suffering from CRPS I.