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 03-01-2015, 02:19 PM #1
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Talking Local steroid injections

Hello all,

I want to share this as it's made a big difference in my pain. Also I'll put a side note on an article I read recently about local steroid shots relieving symptoms that look like CRPS but aren't. I know we have some new joins and thought this might help somebody.

My pain has stayed fairly localized to the areas within a couple inches in all directions of my surgical incisions, which sadly are quite large. I scar really badly and just adhese everything down. A couple months ago with pain off the charts I saw my surgeon thinking we may need to go back in (God forbid!) and I saw a new Phys. Med doctor who is a genius with ultra sound guided injections. In an attempt to keep me out of the OR he did a set of injections in the surgical area while watching on US in December and another in January after a positive response to the first. The scar tissue is softer and moves better. It had felt like quickcrete in there. I have about nine inches total length on my two incisions. One thing he did was "make room" in his words by forcing saline, steroid and lidocaine into the tightest areas, one of which was staying numb and worrying me quite a bit. These have made a big, big difference for me and I am now getting sensation in the numb area. My pain is better, it is not gone by any means but it is at least 50% better and I can walk and stand longer. This means stronger rehab! I still discolor the same but am more comfortable. I know my situation is unique because I have physical compression from all the scar tissue, but I know others of us are in the same boat. I thought this might be something someone else could use. I must emphasize, it was not pleasant "making room" and there can be risks in doing injections or hydrodissections. However, with a competent practitioner and US guidance the outcomes are better. I myself would never let anyone shoot blind anywhere near nerves...
An interesting article of note can be found here for new joins who may or may not have CRPS. Not quite the same thing as I had done but interesting info that might make a world of difference in the right circumstances.
http://www.pain.pitt.edu/paincontent/news/PMNews.pdf

I hope the link works! If not the article is called "Peripheral Nerve Block Relieves Symptoms Mimicking CRPS".
Sending Healing Love, Littlepaw

Last edited by Littlepaw; 03-01-2015 at 06:31 PM. Reason: Addition
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Old 03-01-2015, 06:04 PM #2
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Very good news!
I hope you even mend more...
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Hope for better days.....
Russ
okska'sssini ómahkapi'si
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Old 03-01-2015, 07:08 PM #3
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Thanks Russ!

It's not for everybody but for overachieving scar formers (One of my many talents ) or those with soft tissue impingement, the shots can sure help. It's been almost 8 weeks since the last set. I wanted to make sure they held before saying anything but I am pretty sure I'm staying out of the OR. My surgeon is thrilled, he didn't want to go back in any more than I did.

LP
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Old 03-01-2015, 07:39 PM #4
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You truly are a "student of the game" Littlepaw!

Very happy that you have found something that works for you and is helping with your pain.

A good reminder that we all are our own best advocate for our health care. Don't hesitate to continue to get new opinions.
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Old 03-01-2015, 07:57 PM #5
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I nearly died laughing before the first round when the PM&R doc said "How are you with pain?" I said "you're joking right?" He kindly kept asking if he was hurting me and was I okay. Seemed shocked I tolerated it well. I think even our best doctors don't know what we live with. There's not a one of us that's faint of heart.

LP.

Last edited by Littlepaw; 03-02-2015 at 09:11 AM. Reason: Spelling
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Old 03-01-2015, 10:44 PM #6
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Wonderful news LP! Thank you for sharing your experience (especially with us newbies)!

After meeting my new ortho and explaining my intense pain with my 2nd euflexxa injection, he brought in the US for the steroid/lido injection he recommended (and I hesitantly agreed to). The whole time he kept telling me to let him know if it hurt. LOL

Once thing I noticed, besides pain returning as soon as the lido wore off, is a dark area where he did the injection. Like where he put the needle in. At first I thought it was just a deep bruise but now 16 days later, it's still there.
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Old 03-02-2015, 08:50 AM #7
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Hmmmm,

I wish yours had gone better! I too have had injections, a couple years ago before the whole mess, that did not go as planned and didn't help any. Steroid can cause bruising and skin color change. There's a lot of operator dependence as well as individual reaction. I noticed with this PM&R doc that the shot looked more diluted. When I had a shot two years ago it looked like milk in the syringe, really strong and I lost skin pigment. This doctor is more conservative and careful over all. Says he likes to "bathe" the tissue instead of shooting a whole glob in one area. He seems to be able to find his way between tissue planes. I feel really lucky to have found him, he's done a lot of additional training in US techniques and published anatomical studies. Yet another practitioner I drive 3 hours to see! No one in Austin PM&R had the foot/ankle experience of this guy and the ortho people didn't have the US training. Just more reasons to doctor shop till you find a really good one.

FYI, I did not get pain relief right away. It took several weeks before things started to feel less weird and the scar started to soften. I did feel some of the pressure lighten up pretty quickly and the numbness went with it. I just hope it continues to hold!

Littlepaw
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Old 03-02-2015, 09:09 AM #8
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Considering this ortho referred to RSD as "This RSD you speak of", I don't think he is very well versed in RSD...lol. However, my primary purpose for seeing him is to rule out any active knee injury. I didn't expect immediate relief from the steroid, but at this point (~2 weeks out), if it is/was only tissue inflammation/adhesion I should have some relief. I think that's part of why I have been pushing physically...testing the meds as much as testing myself. Sadly, it seems we both failed.

Continued good thoughts for continued relief for you!!!
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