Efficacy of vitamin C in preventing complex regional pain syndrome after wrist fracture: A systematic review and meta-analysis

Aïm, Florence; Klouche, Shahnaz; Frison, Aurélien; Bauer, Thomas W.; Hardy, P.

doi:10.1016/j.otsr.2016.12.021

Cited by 71 publications

(49 citation statements)

References 18 publications

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“…It was suggested that a daily dosage of 500mg for 50 days reduced the risk level of CRPS-I to half within a year of the fracture. [ 13 38 40 ]…”

Section: Itamin C and M mentioning

confidence: 99%

“…Studies have shown that vitamin C exhibits analgesic properties and proves to have potential role in the improvement of quality of life in the patients having oro-dental pathosis, complex regional pain syndrome (CRPS), and cancer interventions. [ 10 11 12 13 14 15 ] This review was carried out with an intention to explore and provide insights into the analgesic role of vitamin C.…”

Section: Introductionmentioning

confidence: 99%

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An insight and update on the analgesic properties of vitamin C

et al. 2018

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Pain is an unpleasant subjective feeling having implications on both physical and mental realm. Multiple dimensions of pain involving behavioral, spiritual, emotional, and cognitive changes have been studied and pathways elucidated. It is stressed that the nature in which pain is modulated and perceived at a higher center is a complex phenomenon. One of the main goals of pain modulation is to modify pain to a more tolerable level, rather than its complete eradication. Different pain management interventions were tried but have effects that are more adverse. Till date, the only reliable pain blockers are analgesics and anti-inflammatory drugs in the form of opioids and non-opioids. Despite this, most of the drugs are ineffective at various levels, furthermore, adding to complications. Thus, there is an urgent need for effective intervention with minimal side effects. Ascorbic acid, popularly known as vitamin C, has shown to exhibit promising analgesic properties. The literature is sparse with the usage of the drug in various forms of pain. This review focuses on the dynamics and kinetics of vitamin C and its usage in various forms of pain. With minimal adverse effects, the drug is shown to perform well in different types of pain disorders, thus paving way for alternative interventional agent for pain management.

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“…It was suggested that a daily dosage of 500mg for 50 days reduced the risk level of CRPS-I to half within a year of the fracture. [ 13 38 40 ]…”

Section: Itamin C and M mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An insight and update on the analgesic properties of vitamin C

et al. 2018

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“…Previous research has indicated that surgical patients have high vitamin C requirements and supplementation with >0.5 g/day vitamin C is required to restore normal vitamin C status in these patients [22]. The results of these studies have been pooled in various combinations in a number of recent meta-analyses [48–52] and all, but one [50], concluded that the evidence indicates that daily administration of vitamin C can decrease the incidence of CRPS following distal fracture surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Calcitonin + 3 g/day vitamin C (N = 11) for 2 weeksii. Pain relief in 73%, marked ↓ pain in 45%Uncontrolled prospective Arthritic joint replacement surgery [54] a 500 mg/day oral vitamin C (N = 34) for 50 days0% CRPS cases Paget’s disease of bone [58]3 g/day oral vitamin C (N = 16) for 2 weeks↓ Pain in 50%, no pain in 20% (within 5-7 days)Case report Rheumatoid arthritis [56]50 g IV vitamin C twice/week for 4 weeksBefore: 100% pain (QLQ)After: 0% pain IV intravenous, VAS visual analog scale, QLQ quality of life questionnaire* P < 0.05 a Study was included in CRPS meta-analysis [48–52] …”

Section: Introductionmentioning

confidence: 99%

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The role of vitamin C in the treatment of pain: new insights

Carr¹,

McCall²

2017

J Transl Med

115

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The vitamin C deficiency disease scurvy is characterised by musculoskeletal pain and recent epidemiological evidence has indicated an association between suboptimal vitamin C status and spinal pain. Furthermore, accumulating evidence indicates that vitamin C administration can exhibit analgesic properties in some clinical conditions. The prevalence of hypovitaminosis C and vitamin C deficiency is high in various patient groups, such as surgical/trauma, infectious diseases and cancer patients. A number of recent clinical studies have shown that vitamin C administration to patients with chronic regional pain syndrome decreases their symptoms. Acute herpetic and post-herpetic neuralgia is also diminished with high dose vitamin C administration. Furthermore, cancer-related pain is decreased with high dose vitamin C, contributing to enhanced patient quality of life. A number of mechanisms have been proposed for vitamin C’s analgesic properties. Herein we propose a novel analgesic mechanism for vitamin C; as a cofactor for the biosynthesis of amidated opioid peptides. It is well established that vitamin C participates in the amidation of peptides, through acting as a cofactor for peptidyl-glycine α-amidating monooxygenase, the only enzyme known to amidate the carboxy terminal residue of neuropeptides and peptide hormones. Support for our proposed mechanism comes from studies which show a decreased requirement for opioid analgesics in surgical and cancer patients administered high dose vitamin C. Overall, vitamin C appears to be a safe and effective adjunctive therapy for acute and chronic pain relief in specific patient groups.

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