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 06-08-2009, 07:13 AM #1
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Default Delayed pain,activity,aleve?

I think I have asked this before but delayed pain I have this problem so much. I sometimes am able to do a lot more in a day but usually the night and the next day or two are torture pain. Yesterday I did so much where at then end I thought I would throw up from pain and now today I even hurt so much. I don't get it and why this happens. There was a time where I thought if I was able to do at the time it was good but now I have to worry about the days ahead. Also I understand the concept of use it or loose it but at the same time where does the line get crossed from using it to doing too much. By pain doctors most have said the more the better and I know at Cleveland Clinic the day pain program it was basically all day on your feet as why I failed out but was wondering where it could damage rather then benefit. On a side note I have heard people talking about aleve here and never thought of this as vicodin sometimes does not even help when in a flare up but now am wondering if should try. I am concerned though with liver issues is this a concern with aleve and how often does one take this or is it just more as needed. Thanks and sorry so many ?'s
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Old 06-08-2009, 08:17 AM #2
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Hi Daniella,

I agree we all have to watch what meds we take that can effect our liver and other organs. Unfortunately for me I am on percocet daily. I try to take either advil or aleve in between the percocet. If I take 2 percocet, 2 hours later I will take advil. Now I'm not sure what your doctor would prescribe, this is just for me.

Also, I am sorry but I do not believe in the use it or loose it attitude. I have tried many different physical thereapists and every time I left crying and in bed for the next day. I think we are all different in our pain thresholds but I do not do well.

I have recently lost about 20 lbs due to pain and stress. The problem is I don't have muscle tone in my arms. I have been told not to use my right arm but I can't not due something. I think we all need to have our activities monitored as to what is right for our own bodies. You have to listen to yours to make sure you are not over doing any specific exercise.

Good luck! Linda

By the way, I have decided I am going to do my own exercises and try to get into a decent shape. The number on the scale doesn't matter as long as you feel good. My numer is lower than it has been in years but I don't like the way I look. So just be careful of the work you are doing and that it doesn't hurt you
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Old 06-08-2009, 08:30 AM #3
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Hi Daniella,

I also suffer from delayed pain a lot!!! I have been away with my nanan for a long weekend break and even though I didn't do a lot of walking as we took it really steady, I am paying for it a lot today and have had to miss school because of it!! It is SO frustrating as I know that if I have had a busy day, I will usually have to pay for it for the next few days and so many people just don't understand!

Someone on the MS forum has a signiture called 'For every day I play, I have to set aside a day to pay' and I can totally relate to it and think it applies to RSD and most other chronic pain conditions also!!

I haven't really found anything that helps with the delayed pain that much and my doctor told me that there isn't really that much you can do about it other than take some pain meds to see if they help a bit. I don't understand the delayed pain thing really either ... I guess it's just another RSD thing to baffle us!!!

I have been onto a Pain Management Program twice similar to the one you went on at the Cleveland Clinic. I had to have about 4 hours of Physical Therapy a day and then see Psychologists and keep active in the evening. It was SO hard and I honestly don't know how I managed to get up 5 days a week for it!! I remember screaming at my mum every day saying that I didn't want to go as I was just too tired and in a lot of pain!! The first PT Program helped a little as it got me walking short distances again although it didn't help with the pain but the second program didn't help at all. My PT's are thinking about admitting me into hospital again sometime soon to do some more intense PT with me before trying Botox as a last resort.

I understand what you mean about the liver issues from medications. I'm not on any meds at the moment other than Ketamine when I am in a really bad pain flare as none helped and both me and my doctor didn't see the point in me being on them if they weren't helping. It was only when I came off the meds that I realised that they really weren't doing anything for me. My Doctor was pretty concerned about the risk of organ damage also from long term use of meds, especially considering my age so thought it was probably best if I came off thme seeing as though they weren't doing anything.

I wish I could help you more but I can't unfortunately. Please just know that I totally understand what you are going through and I hope you feel better real soon!!!

Take care,
Alison.
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Old 06-08-2009, 09:05 AM #4
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Hi. Thank you for your replies and I am sorry for your pain too. A few ?'s see I rarely take as need meds though did last night I took darvocet. Some days though I am in crying pain. My doctor has started me on narontin again,cymbalta,serequel,and klonopin so am hoping something will make a dent. Lizzy so do you take aleve and or advil every day? I agree about having to monitor ones body and how it responds. I have learned to say NO through this with treatment because I know that when a mistake or wrong direction is taken I will pay for a long time in pain and there is nothing that can be done as meds sometimes I still am crying
Ali I can so relate as when I was at the clinic I called my mom crying too. I was 28 at the time but still the amoutn of activity was insane. I think they try to cramp a lot in a small amount of time but one can't always push through so hard. I think the day program was a good concept but needed revising and also more tailored to individual which will be hard. I also know and I am not your age but still being young I hear that a lot about meds. To be honest I have no idea any more what the answer is cause I do want quality of life but also don't want more health problems on top of the already. Thank you
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Old 06-08-2009, 09:08 AM #5
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Default Hi Daniella,

I agree with Linda on this. I donot believe in the, " no pain, no gain" theory.

I am in PT and Paul told me that if I leave there feeling worse then when I went in, then he is doing something wrong. I've been going for over a month and although he says I do have neck injuries and thoracic spine injuries, he has gotten me moving better and in less pain.

I think we really have to set our own pace. I know it's hard because there are some things we have to do but learning to say no is important. I haven't learned that yet either. When someone calls, I go.

As far as the pain program, I was offered that about 8 years ago. I told them no, I knew I couldn't do an all day program 5 days a week. Don't feel bad about not being able to do it, most of us here couldn't.

As far as the Alieve, I would worry about liver damage. It might be ok to use it for awhile until you get the pain down some but I've been told to use Tylenol only. I do have GERD though so I know I can't do the Alieve or aspirin.
It's not only the liver you have to worry about, it's the stomach.

Have you tried Lidocaine patches. I love them. They seem to help with the pain a lot, especially if the pain seems to be worse in certain areas. You can wear up to 3 of them.

Feel better soon.
Ada
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Old 06-08-2009, 09:08 AM #6
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Default muscle relaxers

I also suffer A LOT from delayed pain. My RSD started in my shoulder and spread to my neck and head. If I use my arms for anything too strenous I get horrific headaches. I am pretty sure the delayed pain we get is from muscle spasms. I take Methadone for pain, which works better than the Percocet I had previously been taking. I now use the Percocet for breakthrough pain (which, unfortunately, is often).

I was recently prescribed Skelactin (sp?), which is muscle relaxer. I used to take Soma, which was not nearly strong enough to have any impact on my pain. The Skelactin is so strong that it puts me to sleep, I took it yesterday afternoon after working in the yard and slept for several hours. It did help some, though. I usually only take the Skelactin when I go to bed, that is the first time I took it during the day, because it's so strong and makes me so tired.

Maybe a muscle relaxer would help with your pain. It might be worth asking your doctor about it.

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Old 06-08-2009, 09:18 AM #7
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You guys are the best thank you. I needed the replies today I feel sad and alone in pain. Anyhow I think klonopin is the muscle relaxer. I am not up to the dose I need yet though as I have been trying to work on neurontin and cymbalta increases.
Debbie I am glad you like lidocaine patches but for me they increased my pain level as I can't have anything near my rsd area even a finger. I also tried the lidocaine infusion which increased my pain. I know that these OTC meds do both impact liver and stomach in some. I know some people take Asprin daily I think only a baby one though for heart health? I just mention aleve because someone did here on a post and I thought they had 8 hour ones instead of atking tylenol 4 hours.
Sme of my pain is like no circulation or the tightest rope around my ankle and then it feels like my foot got run over and like a swollen explosion feeling. The no circulation the neuro said is like a muscle spasm aka why klonopin. Feel better to all of you too. Too bad there is not one med with everything and only good side effects.
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Old 06-08-2009, 09:31 AM #8
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If you decide to use Aleve....I'd suggest the liquigel formula.

It works far better than tablets, for me. I guess because it is faster absorbed, etc.

I use Aleve for my arthritis pain, and the new Liquigels may allow you to get by with lower doses like I do. I don't use it every day, and sometimes not even every week. But it is much better for me than even 800mg ibuprofen! One cap of this new Aleve 220mg = 800mg of ibu for me!

Chronic use of NSAIDs increase the risk of heart attacks. Aleve is naproxen and is considered the lowest risk of the bunch, but it is still a risk. All NSAIDs have a risk of GI bleeding. So taking every day, and/or at high dose increases this.
The liver and kidney effects are less common than the other two but do happen.
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Old 06-08-2009, 09:20 PM #9
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Default Nsaids

I can't take them, just one ibuprofen(advil) and within 45 minutes to an hour, it feels as if I'm going to puke blood, very painful. For almost a week after, I must have food constantly in my stomach or my ulcer acts up. (guess it's an ulcer) I found through trial and error that percocet and soma when combined had lower needed dosages and better painkilling properties, as well as fewer side effects. (didn't need as much percocet, which made me nauseous when I took enough to settle the pain) Also on serax, a tranquilizer, and the three combined have made life bearable, with very little sleepiness or other effects. As the pain increased, and I got diagnosed properly, I needed to be put on long acting percocet(oxycontin) and for some reason I needed welbutrin for depression. I consider myself blessed as the meds I'm on have very few side effects as compared to some of the newer drugs, ie neurontin, etc. If your pain continues to increase, you may want to try low doses of a combination of painkiller, tranquilizer and muscle relaxer, for as you are fairly young, the effects of the new meds might be very contraindicated. Also, using low dose multiple drugs have fewer nausea problems. Please research any meds before you use them, the health consequences can be disastrous, and if it's a choice between physical addiction or liver/kidney/whatever damage, well, always pick something that has the lowest risk. Having RSD is bad enough without having some other hateful problem. God Bless ya young one, and all the rest of us as well. Later, Smoke
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Old 06-08-2009, 10:33 PM #10
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Managing rsd, is an hour to hour ordeal, often.
About the "use it or lose it", we all have delayed pain when we go beyond or normal activity levels. UioLi is not meant that we need to lift weights and jog 20 miles/day!
It simply means, that sometimes you hafto work through the pain and stiffness, and loosen up. I myself wake up in pain, and feel better as the day goes on, (if I'm not being too physical). And, my meds eventually kick in.

As far as Aleve, I merely recomended that to DEW, who was having a bad day on Sunday. It's just as a "change up" strategy. Sometimes, when nothing seems to help for the pain, we've got to change our situ. Weather it be stressors, temperature, (sometimes a hot bath/sometimes a cool shower) positional, humidity, meds not working is what I recomended the Aleve for.
Tylenol and Motrin are both useless to me. Tylenol hurts the liver (the FDA is now calling for a stricter warning for Tylenol), and Motrin just makes me ill.
Aleve seems to be the best choice, for me. (Find which one is best for You!)
And, if my meds aren't cutting it at one time or another, I take two.
And, they often help!
Simple as that really.

Good feelings to All!

Pete
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