Can Mecobalamin Prevent Pain Syndrome After Foot and Ankle Surgery? - Summary - 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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Objective:

To evaluate whether mecobalamin can prevent complex regional pain syndrome type 1 (CRPS-1) following foot and ankle surgery.

Approach:
  • Study Design: A single-center trial conducted between June 2022 and May 2025 involving 440 adult patients.
  • Intervention: Patients were randomly assigned to receive either mecobalamin 500 μg or placebo three times daily for 50 days post-surgery.
  • Outcomes: Primary outcome was the incidence of CRPS-1 diagnosed using the Budapest criteria; secondary outcomes included pain (VAS), activities of daily living (FAAM), and quality-of-life scores (SF-36).
Key Findings:
  • 2% of patients receiving mecobalamin developed CRPS-1 compared to 9% in the placebo group.
  • Adjusted absolute risk reduction for CRPS-1 was about 8%; number needed to treat to prevent one case was 14.
  • Patients in the mecobalamin group experienced greater improvement in postoperative pain and functional outcomes.
Interpretation:

Prophylactic mecobalamin significantly lowered the event rate of CRPS-1 after foot and ankle surgery.

Limitations:
  • Conducted at a single center.
  • CRPS-1 diagnoses made by one reviewer using standardized criteria.
  • Baseline differences in functional and mental health scores required adjusted analyses.
  • Magnitude of treatment effects was relatively modest and needs confirmation in larger multicenter studies.
Conclusion:

Prophylactic mecobalamin may reduce CRPS-1 incidence and improve postoperative outcomes.

Sources:

Original Source(s)

Can Mecobalamin Prevent Pain Syndrome After Foot and Ankle Surgery?

  • by Andrea Surnit

  • July 10, 2026

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