Originally Posted by fmichael

Dear Bobber -

From what I've read, it's generally agreed that cortisteroids help CRPS/RSD. See, e.g., Pharmacologic Management of Complex Regional Pain Syndrome, Rowbotham MC, Clin J Pain, 2006; 22: 425-429, at 426, free fulll text at http://www.rsds.org/2/library/articl...mgnts_crps.pdf:

SYSTEMIC STEROIDS.
Steroids have been and continue to be administered by multiple routes for CRPS therapy. After early reports of success with systemic steroids,[26] Christensen et al[27] studied 23 patients and reported that 30 mg/d of oral prednisone was significantly better than placebo.

[26: Kozin F, McCarty DJ, Sims J, et al. The reflex sympathetic dystrophy syndrome. I. Clinical and histologic studies: evidence for bilaterality, response to corticosteroids and articular involvement. Am J Med. 1976;60:321–331.]
[27: Christensen K, Jensen EM, Noer I. The reflex dystrophy syndrome response to treatment with systemic corticosteroids. Acta Chir Scand. 1982; 148:653–655.]

But it's also my understanding that more doctors don't use them because of a general view - that may not be borne out at only 30 mg/day - that their long-term use poses the risk of too many side effects. Pharmacologic Therapies for Complex Regional Pain Syndrome, Mackey S, Feinberg S, Curr Pain Headache Rep. 2007; 11:38-43, at 40, free full text at http://www.rsds.org/2/library/articl...arma_crps.pdf:

In a review of the literature, Kingery[33] concluded that a short trial of corticosteroids had good support from the studies. However, longer courses of corticosteroids have a questionable risk–benefit ratio, and there are numerous contraindications.

[33: Kingery WS: A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes. Pain 1997, 73:123–139.]

See also, US FDA Approved Prescribing Information, METHYLPREDNISOLONE - methylprednisolone tablet - Watson Labs at http://dailymed.nlm.nih.gov/dailymed...-f1f00909f6d1:

WARNINGS
In patients on corticosteroid therapy subjected to unusual stress, increased dosage of rapidly acting corticosteroids before, during, and after the stressful situation is indicated.

Corticosteroids may mask some signs of infection, and new infections may appear during their use. Infections with any pathogen including viral, bacterial, fungal, protozoan or helminthic infections, in any location of the body, may be associated with the use of corticosteroids alone or in combination with other immunosuppressive agents that affect cellular immunity, humoral immunity, or neutrophil function.[1]

These infections may be mild, but can be severe and at times fatal. With increasing doses of corticosteroids, the rate of occurrence of infectious complications increases.[2] There may be decreased resistance and inability to localize infection when corticosteroids are used.

Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses.

[1: Fekety R. Infections associated with corticosteroids and immunosuppressive therapy. In: Gorbach SL, Bartlett JG, Blacklow NR, eds. Infectious Diseases. Philadelphia: WB Saunders Company 1992:1050-1.]
[2: Stuck AE, Minder CE, Frey FJ. Risk of infectious complications in patients taking glucocorticoids. Rev Infect Dis 1989:11(6):954-63.]

That said, the really interesting but controversial rheumatological/anti-inflammatory treatment involves the off-label use of an expensive line of drugs referred to as "Tumor Necrosis Factor-[Alpha] antibodies." Take a look at Successful Intravenous Regional Block with Low-Dose Tumor Necrosis Factor-[Alpha] Antibody Infliximab for Treatment of Complex Regional Pain Syndrome 1, Bernateck M, Rolke R, Birklein F, Treede RD, Fink M, Karst M, Int Anesth Res Soc. 2007;105(4):1148-1151, free full text at http://www.rsds.org/2/library/articl...teck_Rolke.pdf. But this time, there are far more serious side effects. (For anyone interested, note the "black box" warning at http://dailymed.nlm.nih.gov/dailymed...fo.cfm?id=8421.)

I hope this is helpful.

Mike