[kijo]

How do I know if I have good therapist or not.
I have an apt with one already but it was 3 weeks out so I called and talked to her to find out what I could do at home to get the ball rolling instead of sitting in limbo that whole time.
She told me to walk until swelling started then prop up.
She also said that I should move my stiff joints to point of pain no futher and to take a warm shower or bath first to relax everything to make it easier.
But she also said like the Dr said that I can put ice on swelling.
I told Dr that warm soaks felt better he said that was fine too.
So I am just a little afraid that I have people that really don't know to much about this.
I have an apt for tomorrow for a second opinion with another pain management Dr to see what he says.
Depends on what he says as to if I go for a 3rd opinion which IF I do I think I will get it with a neurologist and see what they can tell me.

But my problem is HOW do I really know if a Dr knows what he is talking about and HOW do I know IF I should really just walk away and try another.

I am really hoping to find a really Good therapist that knows what it is and how to help it but there again I have no idea whats the best way to deal with this as far as therapy goes.

If any of you can give some ideas on what to look for as far as a Good Dr and Therapist go I would be really Greatful.

Can you all share with me what some of the common things I should be having to do in therapy?
I have seen something about some kind of treatment in water and vibrations.
Then some things abou a TENS treatment and then another tcds treatments which I have not clue what these actually are.

Any help advice and or suggestions will be Greatly appreciated.
Thanks
kijo

[Nanc]

Hi kijo!

From what your therapist told you, I would be a little wary of her. I do not agree with her advice for you. Some folks will differ in this opinion, but ice it the worst thing you can put on RSD/CRPS. It is a well-known fact that it is bad and can cause spread. And pushing yourself until you swell and cause pain doesn't sound too good either.

You need to find a doctor and a therapist who is very familiar with RSD/CRPS and treating patients with it. I personally did not benefit from physical therapy, it actually caused more problems for me. There are many on here that have benefited from it and hopefully they will chime in on what to look for in a good therapist.

Good luck with your appointment tomorrow.
Nanc

[catra121]

Originally Posted by Nanc

Hi kijo!

From what your therapist told you, I would be a little wary of her. I do not agree with her advice for you. Some folks will differ in this opinion, but ice it the worst thing you can put on RSD/CRPS. It is a well-known fact that it is bad and can cause spread. And pushing yourself until you swell and cause pain doesn't sound too good either.

You need to find a doctor and a therapist who is very familiar with RSD/CRPS and treating patients with it. I personally did not benefit from physical therapy, it actually caused more problems for me. There are many on here that have benefited from it and hopefully they will chime in on what to look for in a good therapist.

Good luck with your appointment tomorrow.
Nanc

I agree with Nanc...I would be cautious about the therapist. It doesn't mean she is bad...but I wouldn't necessarily follow her advice without having even really seen her either. Ice...THAT I would avoid at all costs. The first time I did physical therapy they wanted to do stim and ice at the end of the appointment for pain relief and that was very bad. I told them ice was painful so we switched it to stim with HEAT...worked miracles for me after therapy and brought my pain levels down to the lowest they had ever been.

Physical therapy was HUGE for me and my regaining motion and function though so I am a BIG believer in it. The key for me when I went from being in a wheelchair and not able to stand or walk at all, was to take things slow. I started out with very simple stretching type exercises. No weight bearing...but just movement at first. Then we GRADUALLY increased the difficulty. This way I was able to do my exercises every single day (never worked so hard that I flared up the pain badly to where I couldn't do anything the next day). The progress was slow and steady but I am back to working full time in a job where I am on my feet all day (with a walker...but still...better than a wheelchair).

I did at home physical therapy the second time around and that was actually much better for me. The physical therapist was aware of CRPS but not experienced in treating it. However...she was willing to listen and learn and it was a perfect balance of her pushing me just enough to keep making progress and her not pushing me to a point of it making things worse. What I really liked best about the at home therapy was that every exercise we did WAS something I could do at home on my own. I didn't need any special equipment or anything...so I was able to work on my progress daily instead of just at my PT sessions once or twice a week. The became very important especially later on when (because insurance only allows so many appointments) we went from two sessions a week to one every other week. This was because I was very good at doing my exercises every day but I needed a lot more TIME because progress, while consistent, was slow.

I would probably meet with this physical therapist at least once. Tell her what you feel you need out of treatment, be prepared to educate her about your condition and on how treatment needs to differ than what one would typically do for an acute injury, and see how it goes. If she is open and receptive then she may be just fine...if she gives you a hard time or tries to get you to do things you know are wrong or too painful for you or insists on things like ice...then get away as fast as you can and see someone else. Physical therapy is going to be painful...but if it's going to be successful then it has to be the right KIND of physical therapy that will be worth the pain when you start to improve.

Good luck!

[AZ-Di]

Hi, Kijo,
I agree with Catra and Nanc. I guess because my P.T. was actually my first "advocate". She (they) saw all the classic visual and range of motion issues in my wrist and hand and called my Ortho. surgeon to have him see me ASAP. They had wrongly told me for 3 wks. to ice and elevate.
DO NOT USE ICE!
I had been referred to pain mgt. specialist - bad luck with him - he had to "google" CRPS.
Finally found my own pain mgt. specialist and what luck! Not only was she familiar with RSD/CRPS she had it in her foot as a teenager and is now in remission. She even used a wheelchair for a couple of years.
She does my nerve blocks using both flourscope and ultrasound. She has me on a whole "cocktail" of meds as well. I don't like the drugs much but for now I guess they are neccessary.
I recommend asking your primary care Dr. to refer you to a good one who may be familiar with your condition. Then try to have them coordinate your care, such as having everyone share info. Your therapist and Surgeon should share records with pain mgt. and vice-versa.
P.T. should work you enough at least so you don't lose any more, so there is still some pain but they should not push a crps patient as far as they normally would because it can worsen the cycle of pain.