Quote:
Originally Posted by vsue65
Thanks so much for your insight. So, do I go ahead with the lumbar sympathetic block? If I do get some relief, is that a positive diagnosis? It sounds like the relief is very temporary and more injections will be necessary. If so, how long do you have to wait between injections? As to the physical therapy, do you have any suggestions on specific things that should be targeted? Is ultrasound effective? My ankle is still pretty swollen and sore. I MRI showed that I have a slight tendon tear. The doctor said that it should have healed by now... but it hasn't. So, I have a lot of pain in my ankle. I know I sound like I am rambling, but again, I feel like I am running around in circles.  |
There is really nothing that will give a "positive" diagnosis of rsd. The final diagnosis is based on a thorough exam, past medical history and lots of tests.
A block is generally one of the first things that is done when rsd is suspected. Definitely get it done. The problem with them is that they may or may not work. If the block gives you no relief from the pain, it doesn't mean you don't have rsd, it means the pain is SIP(sympathetically independent) rather than SMP(sympathetically maintained). If there is relief, the pain is still SIP and it's likely a series of blocks will continue to help. Sometimes it doesn't help and eventually quit helping at all. Docs will generally schedule one or two a week depending on how they like to do things.
Any injury in a rsd site will take a very long time to heal. Circulation in the affected area is compromised which in turn hinders the body's ability to heal. It's the most likely reason the tear hasn't healed yet.
None of us respond to treatment, meds or even physical therapy(PT)the same way. Because you have a tear in a tendon, PT for you will be different than someone with straight up rsd. They're not going to risk making the tear worse, possibly completely tearing it to the point surgery is needed. That wouldn't be a good thing. PT will have to decide how to approach things for you just as they don't treat everyone with back pain the same way.
The only advice I can think of at this point is to get the block done, don't push yourself in PT to the point it has you in agony because that will make rsd worse in the long run. The saying no pain, no gain, does NOT apply to us....ever! Ice should never be used because it constricts the blood vessels even more and as I said before, the circulation is already compromised, not to mention it just increases the pain. Keep moving is key. If you don't use it, you could lose it. I almost lost the use of my leg due to not being able to walk on it because of the pain. It was hard, but I'm still walking today after a round of water therapy. Maybe you could look into that. It really is 10 times better than land-based therapy for us. If possible, warm water is the best.
Karen