Efficacy of salmon calcitonin in complex regional pain syndrome (type 1) in addition to physical therapy

Abstract

The aim of the study was to assess the efficacy of salmon calcitonin, which was suggested as effective in the treatment of complex regional pain syndrome type 1 (CRPS 1). Patients who had suffered trauma to their upper extremities and developed CRPS 1 were included into this randomised, controlled single-blind study. The diagnosis was made according to the clinical examination and scintigraphy. The evaluation parameters were: pain [visual analogue scale (VAS)], the angle of dorsiflexion (DF) and palmar flexion (PF) of the wrist, distance between the fingertip and distal palmar crease (FT-DPC), allodynia, hyperalgesia and trophic changes. One group received paracetamol 1500 m/day and the other group salmon calcitonin 200 IU/day for 2 months. All of the patients participated in a physical therapy and exercise programme. A total of 35 patients were divided into two groups, who were found to be similar for age, body mass index, period of trauma, period of rest in a plaster splint or bandage, the duration of symptoms, VAS, DF and PF angle, FT-DPC, presence of allodynia, hyperalgesia and trophic changes (p>0.05). The control examination showed similar results for allodynia, hyperalgesia and trophic changes, whereas remarkable improvement was observed in the rest of the parameters within groups. On the other hand, between the two groups there was no significant difference in any of the parameters (p>0.05) This randomised, single-blind study showed that all of the patients with acute CRPS 1 in their upper extremities after trauma, who were treated with either paracetamol or calcitonin along with physical therapy, recovered in all parameters significantly, but without any difference between groups. We can conclude that calcitonin does not make any favourable contribution in the treatment of patients with acute CRPS 1; physical therapy combined with only a simple analgesic is an efficient means of therapy.

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

“…However, the two placebo-controlled trials of the five in the meta-analysis produced conflicting results. A more recent study found that calcitonin was no more effective than paracetamol in improving pain and function in CRPS over a 2-month period in patients receiving physical therapy following upper limb trauma (Sahin et al, 2006 Level II).…”

Calcitonin in Osteoporosis

“…In this condition, calcitonin has also been reported to improve physical performance and lengthen the walking distance [151]. However, in more severe cases of neurogenic compression, the effect of calcitonin was poor [146], and no substantial clinical improvement was obtained by adding nasal calcitonin to physical therapy in patients with complex pain syndrome (type I) [152]. Improvement of pain has also been observed in metastatic tumors with bone localizations [153][154][155], where the decrease of bone resorption activity and consequent reduction of bone erosion may affect the painful symptomatology.…”

Treatment of complex regional pain syndrome: a review of the evidence

“…In addition, the subjects were randomized to a two-month regimen of nasal calcitonin or oral paracetamol. At two months, Sahin et al 6 observed no intergroup differences pertaining to pain, range of motion, allodynia, hyperalgesia, and trophic changes.…”