Originally Posted by fmichael

Maybe 8 months after I got RSD/CRPS in both feet and ankles following an injury to the tendons (as confirmed on MRI) on equipment at the gym, I fell victim to a physical medicine doctor at Cedars Sinai's pain clinic who determined that my feet had splayed, requiring more support than was available with an ordinary orthotic. Without consulting any of the pain docs, she put me in "ankle/foot orthotics" (AFOs): rigid pieces of molded plastic, support built into the foot piece, which was hinged to a Velcro strapped piece around my shins. Due to the hinge, I had no later (side-to-side) range of motion, whatsoever.

At first, they were great, and I could walk blocks without pain. That probably lasted all of a week. After that, it still hurt to walk, but the AFOs made it easier, at least until I didn't have to be on my feet, then there was a great swell of relief as I could take them off, followed - maybe an hour later - by the onset of intractable pain that wasn't touched by up to 20 mg. of oxycodone.

Eventually, I realized that I was in a vicious cycle, and was persuaded to drop them entirely, at which point my overall pain levels dropped significantly. Once more I had to learn the lesson, immobilization and RSD don't mix! (The casting of both feet shortly after the injury having really brought on the RSD in the first place.)

I would advise anyone to avoid a brace to the maximum extent possible, where even now, as my bare feet hurt, all I have to do to get some temporary relieve from the deep internal pain in just shake them a bit. And I understand why so many pain docs will tell patients to avoid guarding the limb at all costs. (Although the real danger is said to be atrophy.) That said, if you absolutely require something to keep your arm from avoiding contact, etc., I would get something as flexible as possible, and then make a point of slipping out of it at least a few minutes every hour in order to fully mobilize the limb. It's that important.

Mike