Can Mecobalamin Prevent Pain Syndrome After Foot and Ankle Surgery? - Report - MDSpire

Can Mecobalamin Prevent Pain Syndrome After Foot and Ankle Surgery?

Postoperative rates of complex regional pain syndrome type 1 and pain and functional outcomes may improve among patients receiving prophylactic mecobalamin following foot and ankle surgery.

  • By

  • Andrea Surnit

  • July 10, 2026

  • 3 min

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Clinical Report: Can Mecobalamin Prevent Pain Syndrome After Foot and Ankle Surgery?

Overview

Prophylactic mecobalamin was associated with a lower incidence of complex regional pain syndrome type 1 (CRPS-1) following foot and ankle surgery. The study reported a lower occurrence of CRPS-1 in patients receiving mecobalamin compared to those receiving placebo.

Background

Complex regional pain syndrome (CRPS) can develop after surgical procedures, leading to chronic pain and disability. Preventive strategies are crucial for improving postoperative outcomes, particularly in high-risk populations. This study evaluates the efficacy of mecobalamin, a form of vitamin B12, in preventing CRPS-1 after foot and ankle surgery.

Data Highlights

GroupCRPS-1 IncidenceAdjusted Absolute Risk ReductionNumber Needed to Treat
Mecobalamin2%8%14
Placebo9%--

Key Findings

  • 2% of patients receiving mecobalamin developed CRPS-1 compared to 9% in the placebo group.
  • The adjusted absolute risk reduction for CRPS-1 was approximately 8% with mecobalamin.
  • The number needed to treat to prevent one case of CRPS-1 was 14.
  • Patients in the mecobalamin group reported greater improvement in postoperative pain compared to the placebo group.
  • Functional improvements in activities of daily living were noted with mecobalamin, as measured by the Foot and Ankle Ability Measure (FAAM).
  • Statistically significant treatment effects were observed, although the magnitude was described as modest.

Clinical Implications

The findings indicate that mecobalamin may reduce the incidence of CRPS-1 after foot and ankle surgery.

Conclusion

Prophylactic mecobalamin was associated with a lower incidence of CRPS-1 in patients undergoing foot and ankle surgery. Further studies are needed to confirm these findings in larger, multicenter trials.

Related Resources & Content

  1. Arunakul M, et al., JBJS Open Access, 2025 -- Can Mecobalamin Prevent Pain Syndrome After Foot and Ankle Surgery?
  2. Obesity Surgery — Trends and Outcomes of Bariatric Surgery in Patients with Inflammatory Bowel Disease: A Comparison of Sleeve Gastrectomy and Historical Bariatric Procedures in US Hospitals from 2009 to 2020
  3. Frontiers in Neurology — Transforaminal versus Interlaminar Endoscopic Approach for Broad-Based Lumbar Disc Herniation under Standardized Postoperative Mecobalamin Therapy: A Retrospective Comparative Study Based on VAS and ODI
  4. conexiant — Postop Pain Differs by Vitamin D Status
  5. The Necessity of Distal Metatarsal Screws in Third-Generation MICA: Insights from a Case-Control Analysis
  6. Complex Regional Pain Syndrome

Original Source(s)

Can Mecobalamin Prevent Pain Syndrome After Foot and Ankle Surgery?

  • by Andrea Surnit

  • July 10, 2026

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