Regarding the osteopenia showing up at month 3 - unless you had a base line prior to month 3 there would be know reason to believe that this was caused from CRPS. Osteopenia in CRPS is usually a much later stage of disease process or in those with a severe case in which by your history this is not the case for you - so I do hope you get it checked out.

Your symptoms above sound more like the healing process - it would not be uncommon for pain to increase in the morning after sleeping as this is when inflammation and stiffness occur due to disuse while sleeping it is also a common symptom as an inflammatory response to the normal healing process, as is the increase in warmth and even twinges of nerve pain.

It also makes total sense the the most uncomfortable thing for you is the driving as this would be when you would utilize the small bones (toes) the most. Have you ever used a 'balance board' for therapy? It is often utilized for ankle sprain/brakes but,I would bet it would be good for you for your toes as well.

Lastly, regarding ROM in your toes - there are many worse body parts to have reduced ROM .. keep up with your fitness routine and don't forget to massage your foot (especially the toes) to facilitate healing and brake up any scar tissue that is forming. Massage + epsom salt soaks + physical therapy = speedy healing and if it truly turns out to be CRPS then all these things will have helped you already.

Will do!

My pain is at its lowest after I wake up (usually no symptoms), it usually increases slightly throughout the day.

Yes actual! I used one in therapy the very day you posted this.

Ok, the only thing I haven't tried is the epsom salt soaks. I'll have to look into it, I thought they were for de-sensitizing the area to reduce pain. Do they offer some healing benefit?

Epsom salt soaks and/or Morton Epsom lotion will help with the
circulation in your foot.

Did anyone explain what happens during a bone crushing injury?

You get damage to the skin, ligaments, the lining around the toe bone (the periosteum) and the bone itself.
http://www.britannica.com/EBchecked/...978/periosteum

You can have lingering inflammation to the ligaments, which have nerves in them, or crushing to the nerves themselves, and the periosteum has to regenerate to do its job with bone remodeling. It is damaged, then it will take time to regenerate.

The magnesium in either the epsom salts or the Morton's I recommended to you before, will help the blood flow to your foot. This will help speed healing and lessen the inflammation caused by Cox-2 cytokines, which tend to cause the blood vessels to constrict where there is injury.

If you get the lotion, which is far more concentrated and convenient than epsom salt soaks, apply it to the ankle, and top of the foot. That is where most of the poor circulation is. It will drift down to your toe. Sometimes the BEST intervention is a simple one.

Make sure your socks do not leave constrictive marks on your lower leg, and that your shoes are not too tight, or tied too tightly. This will compress both nerves, and small blood vessels and impair the circulation to your foot. The redness and warmth may be the blood returning after a long day with some issue preventing good blood flow.

Magnesium does 3 main things.
1) increases blood circulation where it is applied
2) blocks the NMDA pain receptors
3) relaxes muscle and works opposite to calcium which contracts
muscles. So magnesium tends to prevent twitching and cramping.

Yes, Epsom salt soaking helps with the inflammatory response which in turn will reduce scar tissue formation (scarring of soft tissue increases pain and stiffness), this will also reduce pressure upon nerves due to swelling/inflammation and increase circulation which is needed in order to heal. Your body needs proper circulation of blood flow in order to heal. You can give your body a little help by using epsom salt soaks, massage, physical therapy, rest, moist heat and even by using compression socks and or KT tape - all good measures regardless of whether or not you have CRPS.

Based on you and mrsD's advice i got a foot bath and some epsom salts and have done a 20-30 minute soak everyday. It's hard to say anything conclusively but it seems to have decreased by symptoms by about 10-30%. Which, as i'm increasingly thankful for, were (are) mild.

So a big thanks to both of you.

In regards to my original topic, the only two things that seem to cause an increase are time of day (its worse in evening) and some foods (maybe i should try the CRPS diet).