Newbie and question about cortisone injections
 

I was diagnosed 4 weeks ago with "probable" CRPS. I had a rotator cuff repair in July 08, 4 months after a work injury. After months of physical therapy, my pain kept increasing. My range of motion was also worse than before the surgery. I developed swelling in the collar bone area and the side of my neck along with radiating pain from my ear down to my elbow, a creepy-crawly feeling across the back of my shoulder and tingling in the fingers. My surgeon said he was not concerned about my pain that he was more concerned with my function(which I thought was odd because I went to him for pain...my function was not very limited before the surgery). At the urging of PT he sent me for a cervical mri and an emg. That showed slight herniation of c4c5 and that I had carpal tunnel and cubital tunnel syndrome so he sent me to a pain specialist for epidural injections. The pain specialist did not think the disc were significant enough to cause my pain and symptoms, examined me thoroughly and said he thought I may have CRPS due to my blotchy skin and weird symtoms. He started me on neurontin and refered me to a hand specialist for my hand symtoms. The hand specialist said he didn't think I had CRPS and gave me a cortisone injection for carpal tunnel. That was 4 days ago. Today I have a deep stabbing, burning type pain in the palm of my hand and can barely bend my fingers. Is this normal after a cortsone injection? Also my WC adjuster called a little while ago and said that I needed to go for an IME before he would approve any more treatments. He is setting up the appointment now. I guess the fun is just beginning. I don't want this to be CRPS. I am very greatful that someone is finally addressing my pain and hope that WC does not impeed any progress I may make with the PM Dr. Sorry for rambling I am just tired and frustrated.

welcome jan
i am so sorry that you are going through all this
yes the steriods do hurt but it shouldnt be that bad. i hope that it isnt RSD sounds like alot of us tho
i have full body (head to toe and internally ) for about 11 yrs now. im glad that you got into a PM doc hopefully he will and can help the biggest thing is to get treatment right away to help control and possible remission for your rsd. at least you got meds/ nlcoks are a big help to

any questions fire away we will answer
i hope this finds you in lower pain

carrie

Hi Jan

Welcome to NT and this forum.

I am sorry you are dealing with all the pain and discomfort and trying to figure out what's going on. :hug:

I was dx'd with CRPS a couple of weeks ago and have been thru the wringer trying to calm down the pain. I've had 3 steroid shots - two in my right shoulder - about halfway between my armpit and the top of my shoulder on the backside; and one in my neck at the C3/4 (epidural steroid injection).

None of these helped much.

Shortly thereafter, I had a series of 3 nerve block injections in the sympathetic nerve plexus about halfway between my chin and collar bone on the right side of my throat. Oh what a relief it is!! :D

However, I am still having a lot of pain in the brachial plexus nerve area (C3/4) and have developed seconary frozen shoulder. I thought the pain in my upper arm, back, neck, shoulder was from the frozen shoulder. I had a lengthy appt with the physiatrist (pain management) doc today and he says no. I've had all sorts of tests and procedures and the type of pain I am experiencing is not from the frozen shoulder. It's from the C3/4 cervical radiculopathy (thank you Shelley!) and is definitely CRPS.

Anyway, not to detract from you, the steroid shots can cause swelling and some tingling, as well as redness. Not everyone reacts the same to steroid/cortisone injections. Whatever you do, don't ice the area. Heat. I also take neurontin and pain meds (they've not helped much) and heat on a 20 minute on/off rotation.

The doc is going to test me for the iodine allergy I've had all my life to see how bad it is as he wants to do a C3/4 nerve block using contrast dye. I guess it's pretty critical to get it in the right place!!

I am new to this and am learning. I also have MS so am not sure how much that complicates the issue. I've done some research and have a couple of research summaries to read that a doctor friend of mine found for me.

Good luck Jan. I hope they find out what is causing your pain and it's something simple! In the meantime, ask away! There are some very knowledgeable caring people on this forum! It's a great group. Welcome!

Since you mention cubital & carpal tunnel - possible repetitive strain injuries?? - I'm wondering if you might have Thoracic outlet syndrome {TOS} -we have a forum for it too:)
here's the link to the TOS useful sticky thread where you can read more about it-
http://neurotalk.psychcentral.com/thread84.html

do you have neck and shoulder pain - a chronic tightness in the muscles in those areas?
The swelling in the collarbone area is something many with TOS will have.
many with TOS also have shoulder problems - related or not to the muscle spasms and nerve irritation-
it affects the whole upper body

hmm the wrong PT often makes TOS worse also..

Hi Jan,
 

I agree with Jo on this. I read your post a few days ago and was thinking that you might have TOS.

TOS is a hard one to diagnose also. There are TOS specialist that can diagnose it and help you find the right PT for it.

It does take a PT that is familiar with it to help with it. The first PT I went to that was helping me was actually able to help diagnose me with it.

It does cause problems with the hands. The colors will also change with it along with having the pain.

I was also diagnosed with carpal, cubital, ulner and radial syndrome. I have had surgery for rotator cuff syndrome twice, ulner nerve, triggerfinger and TOS. Before getting the surgeries for any always make sure you ask for a block to help keep the CRPS from spreading. They Anesteologist will give it before the surgery.

Also make sure you try everything else first. I had shots to try and help calm down the ulner nerve and triggerfinger and finally had to have the surgery.

I don't usually get cortizone shots. Most of my Drs. have used Lidocaine or zylocaine. They do help for awhile.

If you go to the TOS forum, you will get some great info there. That might help you figure out some of what is going on with you.

Ada