Hi, I'm hoping to better understand what "might" be happening to me?

I had an arthoscopic Knee surgery 6 weeks ago and have been struggling with my recovery. I was told after surgery that I'd be on crutches for 3-4 weeks after surgery and it's week 6 and I'm no where near the concept of walking.

At first I was told that yes, my recovery has been slower than usual but its nothing to be alarmed about and that I needed to be patient. THEN, my physical therpaist was fired for not properly treating me and I was assigned a new physical therapist. Some progress was made to regain range of motion and I was feeling optimistic anbout my recovery, but I plateaued and the pain and stiffness grew worse. The Doctor then diagnosed that I was struggling to regain my range of motion b/c of excessive scar tissue and that it would take breaking up that scar tissue by really PUSHING THROUGH THE PAIN and bending the knee during therapy. I did just that and after a few BRUTAL Physical Therapy session; one in particular where I was in excruciating pain as I forced my knee to complete a full rotation on the stationary bike which resulted in unbelievable pain, scream, sweats, shakes, etc., the Doctor is now concerned that I have RSD and has prescribed me Lyrica.

Today was my first day on Lyrica and I see my orthopedic surgeon on Monday to determine if the Lyrica has had any effect. If no progress is gained with the Lyrica he will then refer me to a specialist (of what sort, I can't recall - it was a lot of information to take in over a quick phone call).

For a while, I was really hard on myself about physical therapy thinking that I was wimping out and unable to handle the pain. Like I was an underacheiver or something and that I needed to toughen up...it was really tearing me a part and I wanted so badly to get better and back in my feet. I'm not a quitter and I wanted so badly to do waht was necessary of me (supposedly power through teh pain) to get batter. Up until the RSD I was so obsessed with my recovery I was CONSTANTLY thinking about my next therapy session and how I was going to deal with powering through the pain an dbending my knee. It has been awful. When the Doctor explained that he was concerned that I was dealing with RSD, I had a sort of relief that there was a reason and it wasn't just me "wimping out", but now I've read how awful RSD can be and I'm scared about how RSD may affect my recovery or even worse my life if it doesn't go away or spreads.

Can anyone share a similar experience and advise me on questions to ask my Dr. about my condition, what to expect, etc. etc.

I'm reading that if RSD is treated early it can be cured, but that early detection is critical. What is early? and was anyone else's first step towards diagnosis Lyrica? What can expect or hope for the Lyrica to do for me?

Thanks so much for your feedback!

Nicole

Sympathetic nerve blocks are often recommended as the first line of defense against RSD - a lumbar block would be used for the lower extremity.

I was diagnosed fairly early, but the wrong treatments were recommended by my RI PM doctor. And my RSD spread from my shoulder to my neck and head, then to the hand and feet and legs and face and hips.

Others on this board will surely answer your question as well, with longer and better explanations than mine. But just be careful - if you have RSD it can spread if you don't treat it quickly and properly.

The best of luck to you. Try to find the very best doctor you can in a teaching hospital or well recognized medical center. I wish that I had.

Lyrica is one of many meds that is written for nerve pain. I took it for a while. For some it causes weight gain. I take Topamax because it is better for head pain.

Sandy

Hi Nicole. I am so sorry to hear that you are going through this. Your story sounds similar to mine. But, mine was a right shoulder surgery. I too had lots of scar tissue and regardless of physical therapy, developed adhesive capsulitus. That was in 1989. I still have a frozen shoulder to this day. I was diagnosed with RSD in the right arm before surgery, but the surgery was necessary. I developed full body RSD following surgery. Right after surgery I was given stelate ganglion blocks, which did help but did not stop the progression or spread. It did however relieve my pain short term.
I also have been told that if diagnosed and treated from early onset you have a better chance of full recovery. So I wish you the very best.
I was given Neurotin. I am not a doctor but I believe Lyrica and Neurotin are some what similar. I was sent to a wonderful Neurologist before the surgery for my right arm RSD and she continued to treat me until she passed. I am currently being treated by a neurologist.
Everyone seems to find a way that works for them and I'm sure you will hear many different stories and treatment plans. I hope everything works out well for you. Please take care of yourself. Don't be too hard on yourself, try to keep moving, but pace yourself. Keep us posted on your progress. Di

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