Hi Jerry,
I am so sorry for you and your wife as I (as well as others on this site) know all to well the devastation rsd causes in so many ways. It seems like the trauma your wife did to her fingers by falling caused the rsd. The cast may have been too tight or she may already have had it but most doctors don't believe how much pain we are in when the initial injury occurs. Most think we are faking it (who would want to fake this pain)??? I am glad her bones have healed but with rsd it is a hit and miss thing. Doctors normally start out doing nerve blocks in the spine that corresponds to the injured area. Sometimes it helps other times it doesn't. I had an initial crush injury to my foot and did not use that foot at all for any reason for a year and a half. If I had an axe I would have cut it off the pain was that bad. Unfortunately for me, my pain mirrored itself into the opposite foot/leg almost immediately and within four months I was completely full-body and could not move at all. My internal organs began not working. It was a nightmare and that was over six years ago but I am surviving. I have tried all the meds, pain meds, lidocaine infusions as well as ketamine infusions and within the last 8 months have gotten off all pain medication (after five years of heavy opioids) and try not to take anything at all. I have found that opioids just mask the pain which is the problem and it does a job on your insides and teeth as well. I put myself on a PT program which is really helping me and I've gotten all natural iv's over the last year which helps me immensely too.

I would tell your wife to try not to take pain meds and try to get the nerve block to start and then some very light PT (with no ice on the injured area). She has to try and stretch her fingers even for the slightest movement each day in order to keep from atrophy setting in. Even if she tries to touch a towel or anything with her bad hand...movement is very very important. I know she will prob scream and say no she can't do it which is totally true but she has to do it a small bit at a time. I almost passed out a few times doing PT in the beginning but I started out with baby movements and then a year later went to a great chiropractor. It is all a "try to see what works for your wife" attitude with treatments. Being a compassionate caretaker for her is an amazing first step for her and you should be proud of yourself for helping her and being her caretaker. Many people and family members just don't get it which I hear from the top docs is normal. Having her be able to deal with the pain while you do the phone calls, etc. is a huge help to her. I have found meditation and breathing helps too. I do pray alot and try to laugh at least one good one a day helps too. Best of luck to you both and let us know how she is doing. We are all here to help you out in any way...just ask. We are one big family now.
Take care,
kathy d