Hi Everyone,

Today was horrible. I started my new physio program today. I have never had an experience like it. When I arrived they made me watch an orientation movie. Then they were to go over my "specialized plan" with me and answer any questions I had. When it came time to go over my plan they physiotherapist did not have my paper work. I waited about 15 minutes and then she came back and told me she still do not have it. Yet they have known I was coming for over a week now! Then she said we would start on my program with out it. So much for me being able to ask any questions regarding it. She took me out to the floor showed me where everything was and then we started. I knew going in that the exercises would be painful and of course they were. I did as much as I could. My range of motion is so limited. But I honestly gave it my all. The thing that bothers me and maybe I am wrong about this....but any other time I have been to physio there is a warm up period usually with a heat pack, tense machine and maybe ultra sound....and then there is the exercise/stretching period followed again by either ice or heat. What I didn't understand about today's physio was I was never given any heat during the whole time I was there, nor was I offered any other kind of pain relief in any form (tense machine etc). Am I wrong here? Is this normal? It just doesn't seem right to me. Then finally at the end of the program I was handed my "specialize plan" which was one sheet long with about 5 exercises/stretches done on the computer and the last few were hand written that day by my physio therapist. To me that doesn't seem like a specialize plan what so ever. Instead I feel like they threw a few things together and added a few on the spot.
After we did the last exercise I was told to get my jacket and I could leave and they would see me Friday for my next appointment. I think I was in shock...I just walked out in a daze and now in extreme pain, called my cab and waited for it. During the cab ride home it took everything I had not to break down in the cab due to the horrible experience I just had and the pain. When I got home the pain was so bad it hurt to breath. I called my mom and took an oxycotin. I was unable to go get my daughter from daycare...thank goodness I have an understanding daycare and they drove her home for me. My shoulder is now so swollen I can hardly move it. The pain level is still at a 9....the oxy is taking the edge off a little though. It also looks like my shoulder area is bruised???? Is this possible??? Does RSD cause unexplained bruising?

I am very emotional right now and very drugged up on pain medications and I am sorry if this didn't make a lot of sense. Please be honest with me if I am wrong about the physio and maybe that is how things are suppose to go? All I know is I didn't feel like a human being receiving treatment for a chronic pain (RSD) but an insurance case that they were just making things up on a fly and really don't care about my recovery or not.

Take care
Karen

That is AWFUL! I am so sorry that you had to go through that. I don't have a lot of experience with physical therapy...just what I went though for 4 months at the beginning of last year and then the exercises I continued to do on my own. But I know that when I went to PT, they began my routine with an ultrasound, then I did a bunch of exercises with the stretch bands, and we gradually worked up from there. Even when we moved to a more difficult routine we always started with the ultrasound followed by the stretch bands. And then we ended everyday with heat and stim (TENS).

Sounds like your therapist was not very professional (not having your plan ready so that you could ask questions and then the sad excuse for a plan you got at the end). Maybe I was spoiled...but if I had had to go through what you went through I probably wouldn't have been able to get through more than a day of it.

Hope things get better for you.

I can't speak for the RSD PT , but for my RSI/TOS PT they always used heat, then ultrasound, then some massage & /or E stim of some type before moving on to the more active therapies. And only to what I could tolerate with out pain increasing.
Then a cool down time also.

For RSI & TOS we usually say don't push yourself, baby steps will get you where you want to go more than overdoing and making yourself feel worse.

I totally agree that a warm up time and cool down time is needed, and all therapies should be only done to what you can tolerate with out pain increasing, and nothing more than that.

If /when you go back they should assess how you felt after the last session, if they do the same exact treatment plan again - I say run away -go somewhere else.

Thanks for the response all,

I have had a horrible night. My shoulder is so swollen and it is bruised?????. I have thrown up due to the pain a few times and even came close to passing out a few times. I thought in the past my pain level has hit a 10...well if that is so last night it hit a 15. I can't even wear a shirt today as if anything touches the area that is swollen my pain goes up that I throw up and almost pass out. At points even taking a breath in causes me so much pain I can hardly stand it.

It feels like over night my pain/symptoms have taken on a whole new level. The only thing is keeping me somewhat sane is the narcotics and not moving. But even that is hardly touching the pain.

Will update you all when my doctor calls me back. I am hoping she will see me today as I feel this needs to be documented and she needs to see the swelling and bruising. I was unsure if i should of gone to the ER last night...but i don't know if there is much treatment they could do for me or not?

Take care,
Karen

Karen,

Trust your gut instincts and the terrible experience you just had. I would not go back to this therapist. Your therapy aggravated the CRPS, which is not at all uncommon, especially during the beginning of a therapy program. The therapist should be more in-tune to this possibility.

There is a TREMENDOUS difference in therapists and you need to find one that truly understands CRPS, is gentle, and has some compassion. I tried 3 therapists before settling on one and he has been a godsend.

I would definitely explain all of this to your doctor (how do you like your doctor?) and ask for a referral to a different therapist.

If you are using a Pain Management Doctor (you really, really should), they are normally way more familiar with CRPS and may be able to make a better referral for you.

Hang in there, your pain flare is likely to subside soon.....and keep us posted!

You did not get good treatment. PY usually does not hurt. Yes it can ache a bit, but not to the degree you are experiencing. That is not normal for PT. I usually used ice after a session. PT usually starts with what you can do, and then gradually they increase your duration. It sounds like they pushed you to the point of pain. That is not good and I would have stopped at that point. I always felt really good after a session, as it was finished with a good massage to relax and calm the mussles. I loved PT and went because it felt good afterwards, a little achey, but good. I think that is what it should do for you. The pain your are experincing seems a bit much for after a session.
Ask your dr. if this is normal for you. good luck and I hope the pain decreases soon. ginnie

Also with TOS, and some other conditions, there is what is called "delayed pain" - sounds like you are having some of that.
{ the pain escalates hours after the activity & can cause a flare up}

Hi,

I have a very good relationship with my doctor. I trust her 100%. She seems to be in my corner and not afraid to go up against Workers Comp and their doctors.

The doctor that designed this "specialized plan" for me is a physical medicine doctor. One that Workers Comp referred me to and not a choice of myself or my doctor. He told me there would be an increase of pain when therapy started but not to this degree.

My doctor has told me not to go back to the physio until we can meet again on Thursday and talk about what the next step is going to be.

Take care,
Karen

Hi Everyone,

Thank you for your responses. They did help. When you are feeling pain like i was/am it is nice to know there are people out there you can reach out too.

My pain was continuing to get worse this morning. My doctor was tied up with a patient at the hospital and was unable to call me back right away. When I explained to her receptionist that every time i moved wrong or stood up too quickly that I would get a stabbing pain in my right temple that would shoot through my shoulder, down my arm and back and made me pass out (dizzy) or throw up, she told me to go to the Emergency room at my local hospital.

Well needless to say, just like I thought, they were unable to do anything for me. But they did treat me with a lot of respect and were very caring. The ER doctor was very honest with me and told me that he felt it was a reaction from the physio therapy but because I have been diagnosed with a chronic pain disorder there was really not much they could do. Starting to wonder if this is going to be the reaction of other doctors out there from now on.

In the meantime my husband had called My doctor and she was finally able to call back. She has upped my dosage of pain medications for a few days and added gravol to the list. It seems to be helping as I have not thrown up now for about 4 hours. I also was able to get a little sleep when I returned from the ER. Shoulder is still very swollen and bruised and pain is still bad. But I am able to tolerate it a little better now that i am not throwing up every time a stabbing pain comes.

My doctor has told me NOT to return to that physio place and we will get together on Thursday (I had my weekly 2 week appointment set up already for then with her). So, I guess I will find out Thursday what the new game plan will be. I have no problem going to physio therapy what so ever...but all I know is I really do not want to go back there!

Jo*mar thank you for your response. I have found that I seem to have delayed pain a number of times. If I do something for too long I tend to pay for it later on...has been that way since my injury. Don't get me wrong I feel pain during the task but it just seems to continue to get worse a few hours later. Not sure if this is normal for RSD or if there is in fact something else going on along with RSD. I am still waiting to hear my MRI results and EMG/NCV results which I think I will find out on Thursday as well.

Thank you again all, will keep you posted if there are any changes.
Karen

hi Karen,

delayed pain has been one of my worst symptoms with RSD. My RSD began with a torn rotator cuff and 2 repair surgeries. After any significant activity involving my arms, I typically develop intense migraines. i have also been diagnosed with occipital neuralgia because my RSD spread up into my head. the migraines cause flu-like symptoms and are a total nightmare!! ketamine infusions have been of enormous value. I tried just about every other treatment first.

I was never diagnosed or treated for TOS. But I have many of the symptoms. Just not the one where when you lift your hands up to the side of your head, they turn white, or something similar. Ain't so Bad Pete can tell you about that one if you are interested.

Good luck to you, I can totally relate to what you are experiencing!! xoxo Sandy