Except nerve damage doesn't explain the nail and skin issues.

I would highly encourage you to look into inpatient programs for children with CRPS for him to attend during the summer, if there is any chance of your insurance covering it.

Actually nerve entrapment can mimick CRPS, it is a necessary rule out. Temp and color changes can definitely be caused by nerve entrapment as it disrupts the neurovascular regulation. A plastic surgeon peripheral nerve surgeon who does lower extremity reconstructions is the person who specializes in this. Even with an NCS that is negative there can still be entrapment of a minor nerve that either didn't get measured or that can be expected to have a low measurement because it is tiny. Some of the smaller dorsal nerves of the foot that go through the anterior ankle don't get tested but could still be symptomatic if damaged or caught up in scar.

so frustrating on the PM! what the heck?!

And the nail changes?

I wonder about that too. It is not mentioned that I know of in the mimicry cases. Though I wonder if blood flow that is dysregulated would contribute. Or there is just the plain old possibility that there is a nerve entrapment CAUSING the CRPS and it's a hybrid animal...

worth checking out either way

Just out of curiousity how is nerve entrapment treated?

Depends on the cause. If is metabolic, musculoskeletal or scar tethering. Some people have underlying thyroid issues that need treating, sometimes there are fascial, scar or ligamentous entrapments that can be treated with either steroid injection or hydrodissections. sometimes PT can address positional imbalances that contribute. Last scenario is decompressive surgery.

I'm thinking entrapment might make sense, given that a lot of his pain is located in the extensor tendons on top of his foot, and he gets pain relief when I stretch his foot in a downward motion. Maybe it releases the tension or something. Honestly, I could stretch his foot all day and I don't think he would ask me to stop. Hoping to get him into neuro sooner rather than later. Waiting to hear.

He's having more heel pain and pain along the sides of his foot today, a stabbing shooting sensation. Blah. Thankfully, he was able to get in the pool today and keep it moving.

So neurology was able to see him when a patient cancelled Friday. Manual exam checked out okay. They said the emg will be done with adhesive electrodes instead of needles. Does this give equally valid results???

The pm nurse called me back and clarified, he doesn't have anything new to offer right now, but will talk to the neuro department and see if they can get him in quickly instead of waiting six weeks. The doctor will call me tomorrow to offer more information. So we shall see. It's just been a roller coaster week, I guess.