Hi,

I'm so sorry that you are going through this nightmare. I found this posted under Useful Websites. I have found physical therapy to be a lifesaver. I got lucky and found an excellent team of PT's who knew about and had treated RSD patients. Anyway here's the post:

There have been references in the literature that physical therapy can aggravate pain and RSD. Yet in every outline of treatment for RSD, the use of physical therapy is emphasized. These two statements seem to be contradictory."

Both statements are absolutely true. Excessive exercise and physical therapy that causes fatigue, pain, and distress to any part of the body, only flares-up and aggravates the inflammation and pain of RSD. On the other hand, the commonest aggravators of RSD are bed rest, inactivity, application of ice, and the use of assistive devices. In RSD, the best treatment is eustress not distress.

Distress refers to the stress of prolonged bed rest and inactivity. Like any other machine, prolonged idling of the body is distressful and causes damage to the body. Especially in RSD, the prolonged bed rest results in aggravation of pain and insomnia. The RSD patients suffer from severe, chronic insomnia due to the constant allodynic pain as well as due to the aggravation of constriction of blood vessels secondary to inactivity. One of the earliest signs of RSD is a restless night with the patient constantly being fidgety and changing position all night as well as having to get up and walk to get some relief.

The second form of distress is too much exercise, prolonged physical therapy.

The RSD patient has to learn that they will have pain with too much exercise, and the patient will have more pain without exercise. The patient will have to find a happy medium. The patient will have to rest and exercise frequently. Three days a week in the P.T. Department is not enough. The RSD patient should continue the instructions of the physical therapist from morning to night with equal periods of rest and exercise. The patient should learn from the human heart which beats approximately once a second for 80 to 90 years without taking a vacation. The reason is the heart beats half a second and rests half a second. The same principle should apply to physical therapy in RSD.


I hope this is helpful.

My RSD occurred following a knee injury and moved to other knee and legs. I was diagnosed early. I have never had a block. I take Lyrica and Cymbalta for the weird neuropathic pain (helpful for me), an NSAID for swelling and pain (helpful) and Clonazepam (a long-acting benzodiazpine that doesn't cause that 4-hour withdrawal thing) for muscle rigidity (helpful). I also do aquatic therapy, short bouts of walking, free weights, and probably most important stretching for the strictures. I do this daily throughout the day. The PT has really helped with the atrophy and contracture problem as well as circulation (have regained some of lost sensation). Treatment seems to be different for everyone. I think finding the right providers is key. Key to my treatment are my internist, psychiatrist, physical therapists, and physiatrist or physical medicine and rehabilitation doc. Also key is that they have worked together.

I have made slow steady progress. I do however have flare-ups but continue to be less in frequency and duration.

Sorry I so verbose. I hope this helps.

Kathy