manipulation under anesthesia & release of MCP joint
 

Hi everyone.

As I have mentioned in previous posts, I developed CRPS following surgery to repair torn cartilage in my right wrist. My CRPS is limited to my right arm and seems to be fairly mild in comparison to the descriptions I have read of what many of you are experiencing. I am in constant pain which disrupts my sleep. I have burning, crushing and stabbing/spasm pain in varying combinations and intensity. I have abnormal hair growth around my wrist and I sometimes have very slight changes in color (sometimes a bit white, sometimes a bit red). My right arm is always a bit warmer than the my left, particularly the hand and wrist.

My hand and forearm are pretty swollen. I have limited range of motion in my hand and wrist. The knuckle of my little finger has particularly limited ROM.

My surgeon has proposed doing a manipulation under anesthesia and a release of the MCP joint. He said the tissue above the knuckle (MCP) joint in my little finger is stuck and preventing movement of the joint. He proposes to use a small needle to 'release' it. He will also inject steroid into my hand (you know, as long as he is sticking a needle in, he might as well). Finally, he is going to 'manipulate' my hand and wrist to basically force movement to increase my ROM.

Has anyone had anything like this done? If so, did it help?

Well you will need to go to PT 5x a week for ATLEAST a month in order to keep that new ROM. I was a PT tech and 1 of my paitents had it done, it was highly painful and its alot of work with PT. However it gave back her ROM and thats what was needed. Now the only thing I quistion about this is you have RSD and personally I wouldnt want to be manipulated like that because I do think it will cause the RSD to spread. In a sense it is a trauma done to your body, hence why they are doing it under anesthesia.

Hi KimA,

I'm not sure if this is the same thing, but I had complications with my right shoulder after rotator cuff surgery, and the shoulder froze. They put me under and basically "ripped" it open (they say it sounds like velcro ripping). I went to PT immediately afterwards (and I mean immediately - I was still loopy from the anesthesia) and they worked with it. I went to PT for 6 days straight, then went down to 4 days the next week, then 3 for the next quite a few weeks. It worked well for me, and I have good ROM in my shoulder. I'm not sure if this is what you're talking about exactly, but I think it's the same general thing. Best of luck!!

Thanks for the replies. I am, of course, worried that the procedure may cause my rsd/crps to spread. I guess I'm willing to take the chance. Yikes!

SloRian, what you had sounds fairly similar. I know I will be seeing the physiotherapist on the day of the procedure and then I will have more sessions for a while.

I am having a bone scan and a bone density scan on Wednesday. (I've never had those before.) Then I have the MUA and release of MCP joint on Friday.

I have been taking vitamin C and will continue to do so. Fingers crossed!

Good luck!! Please let us know how it goes :)

Home from procedure today
 

I had the procedure today. I have significantly improved ROM, mainly in my little finger. I met with the physiotherapist before I went home. We did some exercises, she gave me exercises and instructions for home and I booked my next session.

My hand is very numb from the local my doctor injected while I was under. It will be interesting to see how it feels in the coming days. I'm thinking a flare-up is likely but I have a freshly filled prescription of tramadol to see me through. And I have next week off work.

Oh, that's great! My manipulation worked really well, but my RSD wasn't active when I had it done. I'm so glad to hear yours went well! and especially that you have next week off of work. Reduced stress is really important for healing.

Keep up the exercises at home while the ROM is good - that will help a lot. I hope the extra rest will head off a flare-up.

Just a quick update. I have been working hard on my physio exercises and I am maintaining the increased ROM so far. It is pretty sore though.

Meanwhile, I am trying to keep a flare-up at bay. I have been taking Vitamin C...and tramadol. Strangely, my flare-ups seem to start in my shoulder and I can feel it starting. I have spent lots of time with a heat pack, though, and that seems to be helping. If I can maintain this ROM long term, it will be worth a flare-up.

:)

Yeah, I understand that whole fine balance thing between movement and flare-up. I'm glad it's going well :)

When my son had muscle release surgery for his Erb's Palsy, it did wonders as long as the PT continued. He had to have another after a couple of years because as the PT slowed down it tightened back up. He's probably looking at having another soon. My advice would be to never stop the PT. Use it or lose it, or words to that effect lol. Best of luck, hope the spasms/flare-ups stop soon. xxx