While I am still puttering along with the RIC program, I decided to do my own experiment. I have an infrared thermometer, so I have been checking the temperature of my left (CRPS) foot often. I have discovered that the lower the temperature, the higher the pain. I'm trying to figure out what causes the temperature to drop.

Barring figuring out what the trigger(s) are, does anyone have any thoughts/suggestions on how to keep it "normal" body temperature? I already wear a fuzzy sock (sometimes 3 or 4 of them layered on) and have used a heating pad/blanket but I am thinking something I can function with while keeping my foot warm.

I am planning on discussing this with the PM on Friday (program day). I am also noticing that the amitriptyine makes me fall asleep harder (faster?) but I am still waking several times through the night and haven't noticed any difference in my pain level/parethesia/delayed touch so I am thinking he is going to increase to 75mg this week.

I had asked my doctor when I was young why my leg did this. His response was that the effected area does not get good circulation. I think that when pain is bad, the circulation gets worse, not vice versa.
But then again my doctor told me this when I was 11 so things might have changed

I wish I had an answer for this. There is the whole injured nerve that sprouted extra adrenoceptors that react to cold and cause pain and vasoconstriction, blah, blah, blah answer.....but I am just not sure.

The top of my injured foot is often cold. I thought it warmed after ketamine but yesterday it was showing a whopping 7 degree difference again. It didn't even hurt! And strangely it is not the area that took the big hit nerve wise.

Alpha blockers might help with both circulation and pain. Topical clonidine might be an option too.

I'm glad you're sleeping a little better. That's a start!

Let us know what you find out.

I use a few different things to help with the warmth for my left foot/ankle. I use those foot warmer and hand warmer packs you can buy during the winter...the hand ones are usually cheaper than the foot ones and they work...but the foot ones are more comfortable. I also use heat wraps like the thermacare ones but usually the generic ones as they are cheaper...I like the neck wrap ones to use on my ankle and knee (and arms and shoulder)...they stay better than the rectangular ones in my experience. But when I can't wear a shoe or deal with the touch of even the heat pad or anything else...I use a good old fashioned space heater. We keep the house pretty warm for me anyway...but the space heater helps a lot too. All of these things keep the temperature of my leg/foot up but still allow me to move around and do stuff (space heater limits me to whatever room the heater is in...but it's also portable. I don't get to use that as much anymore because of the baby...but the other stuff works great still.

The way I understand it, the pain we as CRPS/RSD sufferers feel is connected to the sympathetic nervous system. As that part of us starts to feel pain, our body's natural response is to limit the blood flow to that area which results in lower temperature.

I do not have any tips to keep your foot warm and still be able to function. The only time I am able to get out of the house is to go to a doctor's appointment. I am unable to wear anything on my foot, so it does get very cold, especially when we have days like today when it is all of 16*F last I checked. When I am at home, I usually keep my foot next to a radiant heater to keep it as warm as possible. We keep the door shut in that room to keep that room warmer than the rest of the house since my husband does not like the warmth as much as I do. Like many others here, my bed is tented off to keep the covers from touching my foot. My husband made a foot board for my bed that the covers drape over and seal in my body heat. Unfortunately we sleep in two separate beds right now since my husband was worried about accidentally hitting my foot in his sleep so much that he was not sleeping at all. The air space eventually warms up and keeps my foot warm. I do like Catra's idea if you are able to put a sock and/or shoe on. I used to work outside and those foot and hand warmers were a lifesaver in the winter.

My foot seems to do the opposite...gets cold & then starts hurting.

I did bring this up today. Pain psych wanted to see if self hypnosis would work so she had me take off my shoe & sock. She put a sensor on it...80 degrees. Didn't get any warmer with the self hypnosis at all but I probably need more practice on that.

It was a very difficult Week 4 (although PT says the eval week counts). I did not routinely do any of the PT exercises this past week as with all the emotion the week prior brought, in addition to sitting at a 9 pain level, I rested Sat/Sun. Monday I had an appointment & that was about all I could do. Tuesday was my daughters birthday and we went out to dinner, then to my parents for cake..in my mind, that counts. Wed I was home alone most of the day, so I tend to not gallivant around much when I'm alone. Well....Miss SmartyBritches PT says "If you're going to be non-compliant, I think you should just be discharged from the program". Have I mentioned that I can't stand her??? She tells MD that I am 100% non-compliant and wants me discharged. Ugh. I discussed lidoderm patches...doc decided to leave things as they are. I told OT that I have finally gotten my pain to a 6 and feel better going forward doing the home exercises but if I need one day of resting it, that needs to be acceptable.

I digress...I'm working on figuring out easy documentation for all activities as that is what the MD wants for next week.

When I was trying to keep track of my daily activities and exercises I made a check off chart that had all the exercises and daily activities. there was a box for each day of the week and I just checked it off each time I did it and kept the list next to where I sat all day so I could easily update. it was much easier for me than keeping a journal because quite frankly...at the time...I just didn't have the energy or strength to write it all down every day and would usually miss stuff. but making a check mark in a box...that was easy.

I love you! I am so using this idea!!!! Thank you!

You are very welcome...hope it helps and works out for you. My physical therapist was a big fan of this when she saw the chart I made and how I used it. I think that helped us build the trust we had and helped her feel good about spreading out visits so that I could see her for a longer period of time instead of twice a week for a shorter period of time.

The really good PT program I did listened to my feedback and adjusted accordingly. If they increased my routine and it decreased my functioning then we would back up. The PT said that it was a delicate balance of not too much and not too little. She was never rude or demeaning. That just doesn't seem right to shame you. Keep trying your best, but it seems logical to listen to your body. Hope next week goes better, ~mac