Nigel -

Let me think about Questions 1 and 2 a bit, but 3 has me concerned, so I can go there with some experience. My RSD started with simultaneous tears of the peroneus brevis tendons in both feet/ankles on a machine at the gym, as confirmed by MRIs. After 6 weeks of the pain getting worse with my feet in elastic supports and on high doses of anti-inflammatories, my kindly old ortho suggested casting them for an equal length of time in order for them to "rest,"' big mistake. Pain zoomed out of control, both times. I say both times because I was enough of a fool to allow them to be done sequentially, even though the first was a disaster before the second started. This was in 2001. Even saw a well regarded pain doc mid-way through the first, who just upped my dose of Vioxx, a now withdrawn Cox-2 anti-inflammatory that probably contributed to a heart attack I had 3 years later. A rheumatologist finally came up with a tentative Dx of RSD a couple of days before the 2nd cast came off.

A couple of years later I saw a hot young ortho for an unrelated knee issue. He told me that they were then doing test castings for any proposed immobilizing surgeries (ankle fusions, etc.) and if pain cut in at any time from the immobilization, the cast came off then and there, with no surgery to follow.

All I can say is that I would want to consult with a number of excellent orthos AND physiatrists before committing myself again to any prolonged immobilization. There has to be a better way. Not to be flip, but I could see spending 18 hours/day in whirlpool therapy as a much more attractive option. That and some very gentle stretching/"nerve gliding" exercises in physiotherapy. But to tell you the truth, just the thought of 24/7 immobilization is extremely disconcerting for someone who already has RSD/CRPS.

Mike

ps Just out of curiosity, is this treatment being suggested by Dr. Rohr or someone else?