Magnesium for CRPS: elixir, helpful supplement or placebo?

Back in 2009, researchers at the VU University Medical Center in Amsterdam published the result of a pilot study into the use of intravenous magnesium as a treatment for CRPS Type 1. In line with the results of earlier studies regarding the efficacy of magnesium on neuropathic pain, the results were encouraging:

“The results of this pilot study show significant benefits of intravenous magnesium treatment on complaints and quality of life in CRPS 1 patients. Pain reported by patients was significantly decreased.”

For most participants the reported reduction in pain seemed startling, occurring within 20 to 30 minutes, with levels of pain remaining “significantly reduced” for up to 12 weeks. Participants also reported reductions in levels of hyperalgesia and allodynia.

What is the science?

It was hypothesised that “by blocking the NMDA receptor calcium channel, and preventing the influx of calcium and the initiation of an intracellular cascade, magnesium may impede peripheral and/or central sensitization resulting in a reduction of pain.” As a NMDA receptor antagonist, it acts in a very similar way to intravenous Ketamine.

In conclusion, it was reported that “the significant improvement of pain, impairment, and quality of life after the treatment with intravenous magnesium suggest that magnesium has beneficial effects on CRPS 1 complaints. Intravenous magnesium was well tolerated and resulted in mild side effects. These results are encouraging and suggest that the potential of IV magnesium as a treatment in CRPS 1 should be further explored in a large size formal trial design.”

All good so far!

However, with the above study still relatively fresh in the mind, it was somewhat surprising that the results of a further study published in 2013 concluded:

“Administration of the…[NMDA] receptor antagonist magnesium in chronic CRPS provides insufficient benefit over placebo.”

This trial did not write off magnesium entirely, but recommended that any further research on magnesium for CRPS 1 should be limited to the acute phase only.

Hope to despondency in one easy step!

So is that the end of magnesium for established CRPS 1?

Well, certainly in the UK and in all likelihood elsewhere, magnesium, intravenous or otherwise, does not form part of the mainstream treatment portfolio for CRPS 1. There are, however, numerous anecdotal accounts online of people with CRPS embracing magnesium in a variety of guises. There are also alternative practitioners recommending its use. There is mention of magnesium oil spray to rub into affected areas, magnesium supplement tablets and magnesium flakes for foot baths.

Interestingly, an entirely unscientific review of a number of online posts by people self-medicating with magnesium for CRPS, reveals a largely positive picture. Try searching “magnesium for crps”, skip over the scientific results and read the forums.

Of course, the scientists will say that this may be down to chance or even the placebo effect and they may well be correct. However, what magnesium does have in its favour is that, in whatever form it’s taken, not only is it relatively inexpensive but, if the recommended dose is not exceeded, it is reasonably safe – certainly a lot safer than Ketamine!

Also, there is growing evidence that many of us, whether or not we suffer with a chronic condition, need to consume more magnesium. So, frankly, as long as it’s approached with an open mind, is there any harm in giving it a go?