I have RSD in my right ankle and needed surgery in the same ankle or I would probably never walk again. (needed ligament reconstruction). Per PM dr, I had a nerve block the day before surgery and an epidural in the surgery room, to try to prevent spreading.

I am only 4 weeks post op, but so far I have yet to have any spread. I think along with the risk of any trauma (surgery) causing spread, the concern of being immobolized (casted) is also a concern for spread. I had developed osteopenia from being in a boot for 7 months so my surgeon is being extra careful post op. Instead of leaving me casted for 6 weeks as would be normal for this surgery, he took me out of cast at 3 weeks and put me in air boot and started light weight bearing.

So although I am not far enough along to claim no spread from the surgery, I can say if you feel you need to proceed with surgery, make sure the drs take precautions that may help minimize the risks. Its a very scary decision. We know from experience how awful the pain is with RSD and noone wants it to spread, but sometimes it wortb the risk. My deciding factor was that my drs felt like there was a chance of remission or pain relief because I could start moving and get out of that boot.

Good luck with your decision.