Needle injection in CRPS area... (bier block)
 

I've had two bier blocks now, and I'm sheduled for another one next friday. Both times they've injected medications into my foot, where I have the CRPS.

Can anyone give their opinions on the safety of this? I'm reading but I can't find much info on it. But some sources tell me it isn't safe to inject a needle into a CRPS area. And that it can make things worse and cause spreads. I've also read that just a needle can cause CRPS in the first place...

I was told by my dr to not let anyone put a needle or anything else like a blood pressure cuff on my rsd area. I was told that after I had accupunture and they put needles in that area and caused spread of my rsd. My pm dr told me after the fact unfornuately for me, but at least I know for the future. My opinion as well as my drs is DO NOT LET THEM PUT NEEDLES IN YOUR RSD AREA EVER!!! Maybe they can find another spot to put it in. Good luck whatever you decide. I would get more drs opinions on this as well. Take Care.

Thank you for sharing about that needles.I have tried blocks in my leg 2 times,hurt really bad in my RSD leg.Could not get the response we were looking for refused the 3rd.if it does not work why do it!!!!
Question what is it about the ebsons salt??what do you use that for?and How?

Hi Moosey, I'm not exactly sure what epsom salts do, but there supposed to be good to soak in. I was told about them first by Allanira. They do help calm my nerves a little emotionally as well as physcially. I hope if you try them, they help you too. Take care.

thank you..You know I was also wondering if anyone gets mouth sores?Along with all the rest of the rsd..I get blood sacks in my mouth then they pop,its gross.My memory is not as good as it was.I was a good speller,now I really question my-self.I forget what I read and from who.I have to return and return..Oh well I guess there is worse.

Hi moose,

Epsoms can be great things....they work by blocking pain receptors in calcium channels. I think lol. Always use the unperfumed kind.

Use a couple of tablespoons in a warm bath, or put a few tablespoons dry into a damp cloth, fold up, and put directly on burning skin. Works really well on the burns for me.

Definitely never ever any tissue damage in CRPS area (or nearby) - even something as slight as a needle. And when they use a needle in a different limb always ask for a paediatric one as its much finer and causes less tissue trauma. Hence less likely to cause spread...

Good luck,

Bram.

When I was initially diagnosed with RSD, I had the same block as you. My PM doctor told me that it would end all of my pain. It sounded great and I was so excited to have it. I was only 12 at that time so was put under general anaesthetic. When the anaesthetic wore off I woke up and was unable to walk. All of my co-ordination had gone and when I tried walking my leg would kick out in front of me and i'd fall to the ground. I spent over a year in a wheelchair, relying totally on my parents. It took a lot of physio (PT) to get me to learn how to re-walk again.

A few years ago I also developed a ingrown toenail on my RSD limb. It was really infected so I had to have it removed. The needle again caused a bad reaction and I developed myoclonic spasms from it. From that point, all my doctors said that I should never have any operations on my RSD limbs, unless it was absolutely needed.

My advice would be NOT to go through with the block. Since the complications happened to me, I have spoke to so many doctors who have said nerve blocks in RSD limbs is an absolute 'NO NO' as it often causes more damage than enough... I only wish I knew that back then. :rolleyes:

Have you looked into an epidural? If you don't have RSD in your back that may be something to look into. I had one a few years ago with Ketamine in it and it really decreased my pain. It didn't last long (only about 6 hours) but it was worth it and doctors often look into the surgical pain pumps for long term effects if it works.

Take care and I hope things work out for you.

Alison

I have the odd mouth sore, but not as many as I used to - for anything in the mouth I absolutely swear by Manuka honey. It's amazing stuff. A few years ago I had to go to the doc with this massive sore that just wouldn't go - I tried all sorts, nothing worked. In the end in desperation I went to my health food shop and asked them, and they said Manuka. It was expensive and I was pretty skeptical, but I like honey so I thought if it didn't help I could eat the darn stuff! Within two days my sore had healed, and was completely disappeared within a week. I've used it loads since then, and on my daughter who gets them sometimes. It's fab and I can't recommend it highly enough lol. Just make sure you get the decent stuff from New Zealand with a Manuka factor of at least 10.

Best thing is there's no side effects and it's very gentle on your system. Plus as a bonus, honey doesn't go off, so one pot lasts for years!

Bram.

Thank you so much.I was wondering about the mouth sores.They really hurt.I will have try that.I am so glad I found this site.I am really touched.:

Injections in the area where you have RSD/CRPS should never be done. It's dangerous.

Typically...for injuries in the lower part of the body they do injections in the back. Lumbar sympathetic block is the kind I had initially (RSD started in my left ankle). For hands/arms they typically do the injection in the neck.

It's always important to remember that ANY injections, blood draws, etc can cause the RSD/CRPS to spread. Done correctly the risk is reduced but still there. That doesn't mean you shouldn't have the treatments as they are going to be your best shot at remission...but you need to go in with eyes open and know the risks. ANY trauma can cause spread.

Spread from injections used to treat RSD/CRPS is rare but does happen. Unfortunately I know from experience that it can happen. I now have RSD in my back, both arms and hands, and my neck after spread from my last LSB.

I am so sorry to hear that.I have had the back injections too..3 but told them no more.They kept saying it sometimes takes more.I told them 3 was enough.Why keep trying...This is a tough problem.I know one thing the cold weather is not helping.

hmmmm
 

Thought bier blocks were only done during medieval times.

Not in affected area Pediatric needles only

Hospital ProtocolRSD/CRPS Patient: Handle With Care!
The Joint Commission on Accreditation of Healthcare Organizations has man-
dated the healthcare institutions that they accredit to assess and treat your
pain. Pain is now to be assessed as the fifth vital sign. Patients have the right
to demand pain control and to be pain free.
Reflex Sympathetic Dystrophy(RSD) also known as Complex Regional Pain Syndrome (CRPS) is a chronic condition characterized by severe burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling and extreme sensitivity to touch. People afflicted with RSD/CRPS are extraordinarily sensitive to certain stimuli, such as touch, movement, and injections.


Patient Tips

1. Bring a written copy of your medication regime. It is important to verify whether your medication regime can be taken care of solely through use of the hospital's
pharmacy. Some medications may not be part of the hospital's formulary.
2. Avoid having ice applied to the RSD-affected limb
3. Instruct all hospital staff to always ask before touching you!
4. Request that the surgery protocols be adjusted so that the pre-op shave be done after anesthesia
(catheter is in place for epidural or whatever). It feels like a lawnmower has been run over your legs when they shave without anesthesia.
Patient Room

1. Whenever possible patient should be in a quiet part of the hospital
2. In a semi-private room, patient should be in the second bed to avoid inadvertent bumping
3. A Zone-Air bed should be used (adjust mattress pressure to patient preference)
4. Heat and air conditioning should be well regulated
5. Standing orders should be issued for patients to have warm blankets
6. Foot Cradle to hold bed linens off body area (will diminish tactile stimuli)
7. Frequent linen changes may be necessary due to hyperhidrosis (increased sweating).
8. Allow family members to bring in clean sheet and pillowcases for patient. Hospital sheets are not soft and can irritate the skin.
9. Place a sign above bed designating affected limb
Procedures

1. Perform a phlebotomy on unaffected limb only
2. Use Pediatric needles (any trauma can cause the spread of RSD to a new site)
3. Warm Alcohol or Betadine wipes with warm running water on outside of package before opening package (these wipes can be very cold to the patient)
4. If PICA site is available, see if blood can be obtained from PIC instead of using vena puncture technique.
Blood Pressure and Pulse Rate

1. Use cuff on unaffected limb only
2. Use thigh cuff if both upper extremities are affected Transport

1. Ask what kind of help the patient needs when transferring to a stretcher or wheelchair (simply touching arms or legs may cause hyperalgesia)
2. Use extreme care over bumps, such as elevator doorways
Feeding

1. Be careful not to touch patient extremities with bedside table
Patient Identification

1. Place red bracelet on unaffected limb
2. Place red dot sticker on patient chart
PO Box 502
Milford, CT 06460
Toll-free: 877-662-7737
info@rsds.org
www.rsds.org

Definitely don't go through with it .. my daughter has CRPS in her foot/ankle/leg and had two injections like that (one from a podiatrist and one at a pain clinic)..they only made the pain unrelenting and worse. Can't help but wonder if she had not had any injections if the pain would have gone into remission and she would be okay now and back to being my happy and healty child!

Thanks for all the input. I've already called the hospital to tell them I'm not doing another bier block.

I'm still going tomorrow. When I went there to do the first two blocks, the nurse talked to me about "other options", and mainly mentioned a nerve block which would help my blood vessels open up. So I suppose she was reffering to the lumbar sympathetic blocks.

I've spend the last days reading up on CRPS. And I'm now reading as much as I can about nerve blocks. I'm gonna make sure I can see the doctor who's in charge of following me up, and talk to her about it!

I'm also considering changing hospitals. But there's only one hospital in Belgium which may be a better choice, and they also recommend contrast baths as part of the physical revalidation on their website.

The first treatment they recommend is what I'm having now too. Injections with miacalcic (calcitonin salmon) and physical therapy. If that doesn't work, their second means of treatment is an IV drip with bisphospanates...

From what I've read the best treatment I can get right now, and as soon as possible is the SLB's...

Good for you!

I hope it goes well tomorrow and you get some answers, and a way forward that doesn't involve sticking things into your CRPS limb...:rolleyes:

I'll be thinking of you, let us know how you get on.

Bram.

blocks
 

I have had the epidural 3 times..lasted about 1 hour on the 3rd. one..but thank you..I am great for all thoughts..

infusions
 

I go to a doctor near where I live for pain management.He spoke about infusions and botoxe..I am not sure who does them.I live in Gloversville ny.But I have to say I wonder about my doctor.I feel he tries,but just not sure what else he can do for me.I have tried so many meds.They work for awhile then nothing.Also a lot of meds bother me. .he ask me how I have been..Good and bad ..Well then I feel like when I say not too good..WHY.Why..I feel like saying duh..its RSD..I feel like I do not dare to tell him bad at times.Like I do not want him to drill me.I am a hard worker.I live on a farm.We have crops to tend too.I work from home too.Plus I have my husband and dog to take care of.i am not one to just sit and cry..I keep pushing..But there are really times when I know I have to stop.slow down..Has anyone had good relief from infusions?????

With close to 3 decades now of ~25 blocks a year I can tell they do help with the pain. But they come with a cost of days recovery from the injection and of not feeling so well until the effects of the injected drug wears off.

Catra, wow! I did not know that blood draws could be an issue! :eek:

When it comes to RSD/CRPS we are still in medieval times. How many here have knowledgable doctors?