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 02-06-2017, 02:38 PM #1
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Hi Jopeful,

I don't why your inflammation hasn't gone down yet. I do see that there is redness and irritation. Fortunately it looks in the photo to be localized and not horribly swollen. Don't get me wrong, I know well that even a little swelling can make a foot angry. Can you clarify, is the pain staying in the big toe or is it now in the ankle too? Nerve irritation of many causes can track upwards. Neuro-inflammation is part of CRPS but there are other reasons that you could be having a reaction. CRPS is a diagnosis of exclusion, so every other possibility needs to be ruled out first. It sounds like there are some possibilities to explore considering the procedure you had can cause a lot of inflammation and infection with foot procedures of any kind is a risk. I am a little concerned about what you call "the burn" and whether that is healing as expected. If you don't feel entirely comfortable with either podiatrist it might not be a bad idea to get another opinion. Doctors don't always have the easiest time acknowledging when a case didn't go according to plan. I'm not saying your doctor did anything wrong but sometimes fresh eyes will identify a new problem. There may be something that needs to be done to allow the wound to heal properly.


I understand feeling worried. It is frustrating when you expect to be well already and don't know why you aren't. Having CRPS in mind as a possibility is not a bad thing but make sure everything else has been considered first. Right now you don't know and my humble opinion is that you need to be reasonably sure there is nothing to be treated before going down the CRPS path. Anyone would be sure to panic looking at 187 pages here. Keep in mind that a lot of people who get better or didn't have CRPS will not be on a forum - our membership is skewed. In the short time I've been here we have had some members come and go because a problem was finally identified and treated successfully. Don't give up on healing. Channel energy into making sure there are no physical problems to address and give your body a little time. Get consults or second opinions if they bring you peace of mind, that is important and it's okay to pursue them. Don't let your pain get out of control in the meantime. Managing it is important for your healing and well-being no matter what is going on with your foot. If you have run down the possibilities for what is causing pain and the doctors believe you have CRPS we are here for you. You're not alone.


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Old 02-06-2017, 02:47 PM #2
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Jopeful,

How long were you on steroids? Did they try an antibiotic?
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Old 02-06-2017, 03:25 PM #3
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I was on steroids for 4 weeks. There is no infection. Swelling is localized to big toe only. But burning also is most of the time to big toe. But sometimes on ankle.
Does sciatica produce burning pain in foot? I have tilted pelvic due to lot of limping. I didn't have sciatica before but.
Burning pain means I feel like stinging. And sometimes I can't locate where exactly it is .
How exactly burning pain feels? I'm taking cymbalta currently and it did make a difference. But when I sat on chair or walk it returns.
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Old 02-06-2017, 06:57 PM #4
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Just chiming in here to agree that a second opinion wouldn't hurt and could likely help. Burning pain in your ankle is odd, and could mean something.

But... if you have sciatica that can cause pain to shoot down that leg and cause pain too. Has it ever caused pain in your leg/ankle before?

Is the toe hot to the touch? Did they give antibiotics when they did the procedure? Because there really could be an infection underneath that isn't seen.

A pain management doctor might help you also to be able to see if it might be CRPS, though they may want to have you see the podiatrist first to rule out other causes.
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Old 02-06-2017, 08:11 PM #5
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4 weeks is a good amount of time on steroid. I wanted to be sure it wasn't a one week Medrol dosepak. I agree with Becca about double checking infection. It can be tricky to identify and treat. If you didn't take something for infection (and even if you did) I'd still keep that on the radar until you're completely sure. That case I told you about where they weren't sure of infection or CRPS was at a large teaching institution and was apparently very difficult to identify.

Pain in the ankle could be nerve irritation tracking its way up or be from sciatica. Why you are having it is the difficult thing to know. I am most concerned for you about the area where you say you don't have true skin. Is that the cause of your symptoms? What needs to be done to make it right? If you are having nerve irritation or early CRPS is that the reason?

Don't give up on finding answers. You may need another specialist. A general surgeon with a lot of wound experience may have a totally different take on everything. If you need to make appointments to get questions answered or get referrals go ahead and do that. You may feel better having a plan of action.

When you ask about burning pain, it is different probably for everyone. I have always felt my own "burning" was more like stinging from nettles or hundreds of fire ant bites. Some have a more cold burn feeling. I think the important thing is managing it no matter what the exact description. I'm glad the cymbalta is helping. I just hope they get it figured out so you aren't having it. If it turns out to be CRPS, you and doctors will deal with it and you WILL make progress. It is a challenging diagnosis but it is not hopeless. Hang in there and keep fighting for yourself. You deserve the best care you can find. It is worth the effort to get a care team that you can get back to health.

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Last edited by Littlepaw; 02-06-2017 at 08:37 PM.
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Old 02-06-2017, 09:04 PM #6
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Quote:
Originally Posted by Littlepaw View Post

Don't give up on finding answers. You may need another specialist. A general surgeon with a lot of wound experience may have a totally different take on everything. If you need to make appointments to get questions answered or get referrals go ahead and do that. You may feel better having a plan of action.
Great Advice! Worrying will not help, but making some positive plans regarding doctors and treatment will not only give you a feeling of control, but hopefully will result in treatment that will help.

Hope you get your answers and relief soon. Stay strong.

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Old 02-07-2017, 10:55 AM #7
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Thanks and appreciate both.
I went to podi again. The wound has to heal more. Because of swelling and inflammation nerves r getting irritated. My toe is still sore.
So once the wound completely heals it will reduce the pressure and nerve will heal. Why the wound not completely healed has no reason. But toe is sore.
It is not CRPS, podi said he is 100% sure.
Does this sound reasonable?
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Old 02-08-2017, 02:28 PM #8
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I would just wait and see and keep up the appointments with your doctor(s). They will have to decide, not an online forum. We can't diagnose this, and you can't possibly expect us to do so.

I hope it's not CRPS, for your sake.
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