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 05-20-2012, 05:12 PM #1
jeichmann21 jeichmann21 is offline
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Default Is it CRPS if you don't have pain?

So, a little background....last June I had a surgery on the posterior tibial nerve right under my knee. It was my 3rd surgery in 8 months and none of these surgeries worked. They suspected I had some sort of nerve entrapment. Anyway, the last surgery in June 2011 left me with complications...complete numbness from the knee to the ankle and half of the bottom of the foot. The doctors said it was due to an irritated sapphenous nerve and it would calm down but may take a year. Well, it has gotten significanly better, but in the meantime I started to experience bouts of splotchy red toes and bottoms of my feet. Mostly on the surgery foot, but at times on the other foot as well. The flare-ups mostly happen if it's hot outside, in the evening after lying down and then getting up again.

When I have the flare-ups my feet are extremely hot and swell, but only slightly. I don't experience any pain with the flare-ups, just discomfort and I really can't stand on them when they are flared up b/c it's uncomfortable. If I soak my feet in cool water or put them in front of the A/C I can get the flare-ups to go away in probably under 2 minutes.

I went to a pain management center to get a sympathetic nerve block but I'm pregnant so they would not do the block. The dr said if he had to make a diagnosis he would say I have a mild case of CRPS. This was based off me telling him about the flare-ups and the fact that the foot that has the flare-ups was about 7 degrees different in temperature (colder) than the other foot.

My long winded question is can I have a mild case of CRPS if I don't have pain?

It's occuring more and more now that it's 90 degrees in Chicago. I can't really go outside without it happening now.
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Old 05-20-2012, 05:22 PM #2
birchlake birchlake is offline
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I certainly would get multiple opinions from professionals as this condition is widely misunderstood, but you do not need to have all of the classic symptoms in order to have CRPS.

It would be unusual not to have pain and would be interesting to see if anyone else chimes in that has had a similar experience, but some of the other symptoms you describe do fall into the CRPS definition.

Last edited by birchlake; 05-20-2012 at 06:18 PM.
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Old 05-20-2012, 06:02 PM #3
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I suppose that anything is possible with CRPS...it really is an odd condition. I will say that not having the pain would seem a bit out of the ordinary...as would your getting relief from COOL water or AC (usually cool/cold anything would flare up CRPS). Definitely would be something that I would want to get another opinion on because if it is something else that could be treated then that would be much better.

I have also read that many patients who are pregnant who have CRPS see a reduction in symptoms while they are pregnant...so there is the possibility I guess that your symptoms right now are mild but could get worse later.

There are probably a lot of other things that could be causing your symptoms too...so definitely would be worth getting another opinion. Would hate for you to possibly have something go undiagnosed and then get worse because a doctor shrugged it off as a "mild" case of CRPS.
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Old 05-20-2012, 06:40 PM #4
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Thanks for the replies.

Really...I thought cool water made the heat from CRPS go down. I know ice is not recommended, but that has helped me too. Again, almost instantly.

I did have the sx prior to getting pregnant. The bouts were not as frequently, so if anything it's worse now, but I think that is b/c of the warmer temperatures outside not the pregnancy.

Not sure what else it could be? Other than the pain factor, my sx seems to line up with CRPS. I hope it's not that.

What type of doctor should I see? A neurologist? I already visited a pain clinic and got the 'mild CRPS' diagnosis there.

Thanks and my hearts go out to everyone on this board!
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Old 05-20-2012, 07:42 PM #5
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Neurologists (to my surprise) are hit and miss on properly diagnosing CRPS.

If you do go to one, do your research and go to one that specializes and has experience in CRPS. Many neurologists have sub-specialties that they practice within.

You could also try a different Pain Management doctor.

The ice can make it feel better (temporarily), but it really is not a good idea. That has been pretty firmly established. Temporary use of ice is one of the treatments of choice for ACUTE, but not CHRONIC pain.

Have you seen Hooshmand's site yet? Some pretty good information on there.

http://rsdrx.com/CRPSABSTRACT.htm
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Old 05-20-2012, 09:16 PM #6
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huh.. interesting set of symptoms. they seem to line up(BUT) one of the things about RSD is that it is only a positive dx when all else is exhausted. Now I haven't seen many cases that do not involve pain but yes it is true not all symptoms show up on red patients and pain isn't always 8,9, or ten some are 1-4 with is uncomfortable . I have not heard ever that cold water or ac usage soothed red symptoms though. that is odd. I hope for your sake you can find a dr to take the time to dx you, but treat yu as it is RSD just in case. this is an odd beast so like they said before me anything is possible. i see a neurologist, spine specialist, orthopedic, shrink, pain management and vascular surgeon. I suggest you see a vascular surgeon, neurologist and orthopedic, all of these areas are noticeably affected, on film and by naked eye. good luck. and I pray that it is a more simple issue and one not very serious.
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