Healing from the Inside Out: Vitamins and Nutritional Strategies for Complex Regional Pain Syndrome and Chronic...

Complex regional pain syndrome (CRPS) and chronic postsurgical pain (CPSP) are postoperative outcomes that present with debilitating symptoms for patients. The recovery of patients with these conditions is complicated by the lack of standardized prevention and treatment strategies. Current literature suggests that vitamin C may prevent the development of CRPS. Due to the overlapping proposed mechanisms of CRPS and CPSP, the aim of this review is to summarize the available data on the benefits of vitamin supplementation on CRPS and CPSP.

A search of the literature for articles published in the last 10 years was conducted. Systematic reviews, meta-analyses, case reports, and articles that were not published in English were excluded. Ultimately, 10 articles met inclusion criteria.

The data suggests that systemic vitamin C plays a significant role in preventing CRPS following various orthopedic surgeries and may possess therapeutic benefit as well. Vitamin B12 improved short-term functional and mental health outcomes as well as decreased neuropathic analgesic consumption. While no clinical studies have been performed on alpha-lipoic acid (ALA), preclinical studies suggest that administration decreases cold allodynia and pain in mice models. Moreover, while no studies have evaluated the effects of vitamin D on CRPS and CPSP, retrospective analysis reveals that CRPS incidence is increased in patients with low vitamin D levels.

The literature reviewed reveals that there may be value in considering nutritional supplementation through vitamins in CRPS and CPSP, however, large-scale, randomized controlled clinical trials are warranted to evaluate the potential beneficial effects of these supplements in patients.