Recent evidence has shown that vitamin C has some analgesic properties and can therefore reduce opioids used during healing. Vitamin C analgesic effect has been explored mostly during the short-term postoperative context or in disease specific chronic pain prevention but not after acute musculoskeletal injuries, which are often seen in the emergency department (ED).
The study's primary aim is to compare the total morphine 5 mg equivalent pills consumed during a two-week follow-up between patients receiving vitamin C or a placebo after ED discharge for an acute musculoskeletal pain complaint.
The investigators will conduct a double-blind randomized placebo-controlled trial with 464 participants distributed in two arms, one group receiving 1 000 mg of vitamin C twice a day for 14 days and another one receiving a placebo. Participants will be ≥18 years of age, treated in ED for acute musculoskeletal pain present for less than 2 weeks, and discharged with an opioid prescription for home pain management. Total morphine 5 mg equivalent pills consumed during the two-week follow-up will be assessed via an electronic (or paper) diary. In addition, patients will report their daily pain intensity, pain relief, side effects, and other types of pain medication or other non-pharmacological approach (ice, heat, immobilization, etc.) used. Three months after the injury, participants will also be contacted to evaluate chronic pain development. The investigators hypothesized that vitamin C, compared to a placebo, will reduce opioid consumption during a 14-day follow-up for ED discharged patients treated for acute pain.
Aged 18 and over;
Treated in ED for acute musculoskeletal pain present for less than 2 weeks;
Discharged with an opioid prescription;
Speaks French or English.
Opioid use 1 month prior to the ED visit;
Already taking vitamin C supplement;
Active cancer;
Treated for chronic pain;
Parallel
Vitamin C
Dietary supplement1000 mg vitamin C taken orally twice a day (one in the morning and one in the evening) for a 14-day period after ED discharge for the treatment arm
Placebo
Other interventionPlacebo taken orally twice a day (one in the morning and one in the evening) for a 14-day period after ED discharge for the treatment arm
Difference in the total morphine 5 mg equivalent pills consumed
Compare the difference in the total morphine 5 mg equivalent pills consumed after a two-week follow-up between patients receiving vitamin C versus patients receiving a placebo during these two weeks.
Pain intensity trajectories
Compare pain intensity trajectories, measured on an 11-point numerical rating scale (NRS) from 0 to 10 (0 is no pain and 10 worst pain imaginable), between both groups with group-based trajectory modelling.
Average pain relief
Patient's average pain relief during the two-week, measured on an 11-point numerical rating scale (NRS) from 0 to 10 (0 is no pain and 10 worst pain imaginable).
Number (%) of participants with side effects
Patients will report which of the following side effects were experienced during the 14-day period: nausea, vomiting, constipation, dizziness, drowsiness, sweating, weakness, or other side effects.
Total morphine 5 mg equivalent pills consumed for each type of musculoskeletal (MSK) pain
Fracture, contusions, cervical pain, lower back pain, MSK pain at other sites
Click on the lead sponsor to view all of their trials.
Centre Integre Universitaire de Sante et Services Sociaux du Nord de l'ile de Montreal
Lead sponsor
Hopital de l'Enfant-Jesus
Collaborator
