Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


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Old 08-11-2010, 11:02 PM #1
MysteryPainMom MysteryPainMom is offline
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Frown flare after physical therapy

My daughter started physical therapy about three weeks ago. Today when she was there, she did weight bearing exercise for the first time. Before that, she did leg lifts and other floor type exercises. Today was the first time she used machines. Tonight she is having a flare. Her pain level is much higher than it usually is even at night.

She still doesn't have a definite diagnosis, but I am convinced that she has RSD. She has all the symptoms, as I have discussed here before. The diagnosis that the doctor put on the prescription for PT was "sensory polyneuropathy." He has told me that it is just as likely that she could have RSD, but that the treatment is the same. Since it didn't say RSD, I am afraid that the PT may not be familiar, or may not be treating her in a way that is helpful for RSD. I know that some things can make matters worse, and I have been trying to not let that happen while we are still trying to get a definite answer about what she has.

Can anyone else tell me what their experience has been with physical therapy? Is it normal to have a flare after PT? Is this a sign that she should slow down?

Thanks!
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Old 08-11-2010, 11:34 PM #2
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My daughter started physical therapy about three weeks ago. Today when she was there, she did weight bearing exercise for the first time. Before that, she did leg lifts and other floor type exercises. Today was the first time she used machines. Tonight she is having a flare. Her pain level is much higher than it usually is even at night.

She still doesn't have a definite diagnosis, but I am convinced that she has RSD. She has all the symptoms, as I have discussed here before. The diagnosis that the doctor put on the prescription for PT was "sensory polyneuropathy." He has told me that it is just as likely that she could have RSD, but that the treatment is the same. Since it didn't say RSD, I am afraid that the PT may not be familiar, or may not be treating her in a way that is helpful for RSD. I know that some things can make matters worse, and I have been trying to not let that happen while we are still trying to get a definite answer about what she has.

Can anyone else tell me what their experience has been with physical therapy? Is it normal to have a flare after PT? Is this a sign that she should slow down?

Thanks!
Dear Mom..I am sorry for the PT flare... My orthopedic surgeon did send me for an aggressive PT schedule..everyday for two weeks ~ 3-4 hrs/day.. It was quite painful, tears to my eyes during every session..and it was driven by a protocol used only for RSD patients..in order not to cause further damage..As far as the flare can't really say because I seem to have constant flare..8-10 pain all of the time.. No less.. but still smiling..Talk with the PT personal in order they are following guidelines for RSD patients....

Hugz, Kathy
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Old 08-12-2010, 12:53 PM #3
MysteryPainMom MysteryPainMom is offline
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Thanks Kathy,

She seems to be a little bit better this morning. She didn't sleep much last night.

We are working hard to get her a definite diagnosis, all while trying to make sure that we don't do anything to make matters worse. Since the diagnosis on the prescription for the PT was sensory polyneuropathy, I don't know what differences there might be in treatment. I will ask the PT next time we go so that I can find out what she knows about it.

I see so many people on here that have had this for years, and many didn't get a diagnosis for years. I want to do my best to keep things from going to the point of no return before someone decides what the best treatment is for her.

She has many of the symptoms, but there are things that we have not seen yet, such as feet turning in etc. I really want to keep it from going to that extreme.

She has an appointment at the end of the month with a doctor at University of Michigan. Hopefully he can get a handle on this. For the time being, we are trying to keep her moving because I know that if she doesn't it will get worse.

I really love this forum, there are so many wonderful people and so much helpful information here.

Thank you again,

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Old 08-12-2010, 03:15 PM #4
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Thanks Kathy,

She seems to be a little bit better this morning. She didn't sleep much last night.

We are working hard to get her a definite diagnosis, all while trying to make sure that we don't do anything to make matters worse. Since the diagnosis on the prescription for the PT was sensory polyneuropathy, I don't know what differences there might be in treatment. I will ask the PT next time we go so that I can find out what she knows about it.

I see so many people on here that have had this for years, and many didn't get a diagnosis for years. I want to do my best to keep things from going to the point of no return before someone decides what the best treatment is for her.

She has many of the symptoms, but there are things that we have not seen yet, such as feet turning in etc. I really want to keep it from going to that extreme.

She has an appointment at the end of the month with a doctor at University of Michigan. Hopefully he can get a handle on this. For the time being, we are trying to keep her moving because I know that if she doesn't it will get worse.

I really love this forum, there are so many wonderful people and so much helpful information here.

Thank you again,

Mom (for short)...

AND we love having you with us on this forum....this place is my glue...

I know with my aggressive PT..I would not sleep the night before in anticipation as it was just murder pain..Two big berley guys beating on my RSD leg..Forcing it to bend the furthest possible and everyday a bit more and more.. Heck, when I would leave the place eachday, I had complete strangers clapping for me..And due to the extreme pain, I would have trouble recalling how to even exit the place...

Yes, please pursue a definative diagnosis soon and in the mean time..keep her moving thru the pain as that is trully important or the pain could freeze her up...Remember, we do not always exhibit every symptom or sign, just another added bonus of our crazy illness. I am cold turkey RSD without pain meds as I have a bad tummy and nothing stays where I put it... I wish you much luck with getting your answers..At this time, I think discussing the PT intentions would be a good idea and continue to move forward being your daughters advocate..She will do well as long you are looking out for her...bless you both and please lean on us to help you...Weeez family here..

Hugz, Kathy
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Old 08-13-2010, 01:27 PM #5
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Originally Posted by keep smilin View Post
Mom (for short)...

AND we love having you with us on this forum....this place is my glue...

I know with my aggressive PT..I would not sleep the night before in anticipation as it was just murder pain..Two big berley guys beating on my RSD leg..Forcing it to bend the furthest possible and everyday a bit more and more.. Heck, when I would leave the place eachday, I had complete strangers clapping for me..And due to the extreme pain, I would have trouble recalling how to even exit the place...

Yes, please pursue a definative diagnosis soon and in the mean time..keep her moving thru the pain as that is trully important or the pain could freeze her up...Remember, we do not always exhibit every symptom or sign, just another added bonus of our crazy illness. I am cold turkey RSD without pain meds as I have a bad tummy and nothing stays where I put it... I wish you much luck with getting your answers..At this time, I think discussing the PT intentions would be a good idea and continue to move forward being your daughters advocate..She will do well as long you are looking out for her...bless you both and please lean on us to help you...Weeez family here..

Hugz, Kathy
Kathy,

We are counting the days until we get to the next doctor. Hopefully this will be the one. It has been difficult because of her age. Those doctors who know most about this will not see a pediatric patient. I am hoping that the one we are going to will be familiar with it. She had an EMG and the results were kind of confusing. I am hoping that this doctor can figure out if it means something, or maybe they can dismiss it and go with the RSD diagnosis.

In PT have you normally done weight bearing exercises, leg presses etc? I think that might be what is causing her the most difficulty. She doesn't have any stiffness, thankfully. I am really glad that her pediatrician mentioned RSD as a possibility in the beginning. I just kept it in mind until they did all of the necessary tests to rule out the many other diseases that could have explained her innitial symptoms. I think that good information will be what saves her. It seems that the worst problems come when people go for long periods of time, even years, without a diagnosis and therefore, without proper treatment.

Thanks again,

Tracy
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Old 08-13-2010, 02:00 PM #6
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[QUOTE=MysteryPainMom;684194]My daughter started physical therapy about three weeks ago. Today when she was there, she did weight bearing exercise for the first time. Before that, she did leg lifts and other floor type exercises. Today was the first time she used machines. Tonight she is having a flare. Her pain level is much higher than it usually is even at night.

Acupuncture seems to have caused a flare and possible spreading to the other side of my body for me. From what I have read, depending on how the PT was done and their knowledge of RSD, it certainly could cause a flare. I would call the MD and try to get better clarification on what he/she wants done.
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Old 08-13-2010, 07:30 PM #7
Lisa in Ohio Lisa in Ohio is offline
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Mom, I use to suffer terribly from PT until I finally got brave enough to tell the therapist when things hurt or that I had done enough. There are plenty of other things that they can use to help RSD without causing severe pain. Therapy can be of great benefit, but you have to take control of what you can do. Good Luck, Lisa
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Old 08-13-2010, 08:23 PM #8
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All that I want to add is that "No Pain No Gain" DOES NOT APPLY TO RSD Patients!!!!Been there done that! Fondly-Carol
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Old 08-13-2010, 08:30 PM #9
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Welcome.

I don't believe in agressive PT for RSD. My arms and legs are messed up and there is no way I would lift weights, do therabands, do treadmills and bikes when I first started out with RSD. I still won't today on most. I volenteer out at the Vet's home and when we exercise, I hand out the therabands but I don't do them nor the weights. I always laugh about the vets doing better then me with all of that stuff.

I spent 4 years in PT and my PCP got rid of 3 therapist that he felt was making me do things I shouldn't. I love my husband and wife team I have. They studied in Holland and don't believe in pushing a patient like most PTist.

I had one therapist that said I could get worse before I got better. My PCP callled her up and said no way. He told her I could get worse and not get better.

Some do believe in the agressive PT, as I said I don't. You can keep mobility and keep going without running marathons.

I hope she gets diagnosed soon. Keep looking for that right Dr., he's out there.

Ada
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Old 08-13-2010, 11:04 PM #10
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Welcome.

I don't believe in agressive PT for RSD. My arms and legs are messed up and there is no way I would lift weights, do therabands, do treadmills and bikes when I first started out with RSD. I still won't today on most. I volenteer out at the Vet's home and when we exercise, I hand out the therabands but I don't do them nor the weights. I always laugh about the vets doing better then me with all of that stuff.

I spent 4 years in PT and my PCP got rid of 3 therapist that he felt was making me do things I shouldn't. I love my husband and wife team I have. They studied in Holland and don't believe in pushing a patient like most PTist.

I had one therapist that said I could get worse before I got better. My PCP callled her up and said no way. He told her I could get worse and not get better.

Some do believe in the agressive PT, as I said I don't. You can keep mobility and keep going without running marathons.

I hope she gets diagnosed soon. Keep looking for that right Dr., he's out there.

Ada
Challenging PT certainly aggravated my RSD. My surgeon said it would, and it did. He also said my shoulder (and probably the RSD) would not improve without the challenging PT. And it did improve (compared to pre-blocks - still a train wreck, overall). He was right on both accounts....thank God for stellate blocks and that they worked for me, otherwise I would have gone postal in PT!
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