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Originally Posted by HouseLite
Hello all, I have a couple of questions maybe sombody can help me with, through my wifes and mine reserch this looks like the right place to ask qustions. I got dx with rsd last week in my right leg, it started about a month ago and from what i read here i am lucky they found it as quick as they did. I have had two nerve blocks ( lumbar ) in the past week. This is where my qustions begin, after my second nerve block my leg feels worse than it did before i went in. My pain doctor also is telling me i should start cuting down the pain medican i am on. If i was to do this i would be in my chair not being able to do anything. Should i listen to him or stick with whats working. I am getting to go back to work ( desk job ) monday and i dont think i could do it with out the medican, my pain level is still at a 6 most days any higher i would be stuck in a chair. Thanks for your help.
Ray
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Hi there and welcome!! I am new to this diagnosis myself (just 6 weeks) and I'm sure that there are more senior members that will have more information than I do. It IS good that you have been diagnosed and treated so early. I have several thoughts about what your Pain Doc has told you.
First, he COULD be asking you to decrease your meds to see if the blocks are working (which they don't sound to be, from your description). Some docs specifically ask that you decrease your pain meds so that they get an accurate "read" on how much the blocks are decreasing the pain vs. the pain meds. However, since your pain levels are not coming down, I would suggest you inform him of that, and possibly start looking for a new pain doc with more experience in treating RSD. If the blocks are not placed in the exact proper place, they will not work and could cause more problems.
My foot/ankle swelled up twice it's normal size after my first block (pictures are on this forum from a few weeks ago). My doc said that was a good sign because the limb had more color (blood flow) and the swelling was temporary and eventually began to decrease (thus improving my mobility and decreasing my pain over time). Also, RSD has a mind of its own, and may get worse before it gets better.
That all being said, managing the pain is CRITICAL for a good outcome with RSD. If you're in severe pain, the nerves are going to continue to be stimulated (and over stimulated thanks to the disorder), not giving the sympathetic nervous system the time to settle down. Also, you will favor your injured limb, not use it
properly (which is CRITICAL for your long-term prognosis), and will throw off your other body mechanics in the process. If your doctor doesn't understand that aspect of RSD, which many don't because it's a rare disease and many docs haven't treated it, then you need to find a doctor that does.
RSD is the most painful of all chronic pain conditions. The pain tends to ebb and flow in most, from moment to moment and day to day. So many things like stress, inactivity, and even the weather or temperature can affect it. Proper pain control, in addition to PT, proper diet, medication, and successful interventions (nerve blocks and the like), are imperative for a good overall outcome. I would talk with your doc, be honest about how the blocks are affecting you AND your pain level on an average day, and take what meds YOU need in order to function.
Many people on this forum are unable to work due to this disease. I am elated you are still able to make it to your job. Do whatever you need to do to maintain your life and livelihood. Prolonged inactivity will ensure you a useless limb, possible spread, and increased pain. Best wishes to you!! Please keep us posted on your progress!!