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First Time Posting Here--Help?
angelswife posted:
Hi Everyone,
I need some input, please! Back in April I broke my lower leg and my ankle (5 bones total). I needed four hours of surgery to put me back together---I had to have bone grafts because I shattered three inches of my tibia (along with the rest of the bones). After 13 weeks in a cast, I "graduated " to a boot and have now started PT. THe PT is tough, but I am dealing with it.
Both the PT and my MD have dxed me with RSD because of all the nerve damage. The pain from that has been driving me nuts, but my MD doesn't want to treat it until all the swelling is gone (6-8 months down the road). So I am trying to manage things on my own.
My question: Is it normal to still need pain meds this far along? I've never had a severe injury like this and I don't really know what to expect. I have been using Percocet since April, and am down to just half a pill at night if I need it. I don't use it every night but am frustrated because I can't get off it altogether. Perhaps it's just too soon?
My MD said he wanted me to stop taking it, although I'm at very low risk for addiction. He said use Aleve instead. I tried and Aleve does nothing for the nerve pain. The Percocet doesn't knock it out completely either, but at least I can sleep through it. I would appreciate any input---thank you!
I need some input, please! Back in April I broke my lower leg and my ankle (5 bones total). I needed four hours of surgery to put me back together---I had to have bone grafts because I shattered three inches of my tibia (along with the rest of the bones). After 13 weeks in a cast, I "graduated " to a boot and have now started PT. THe PT is tough, but I am dealing with it.
Both the PT and my MD have dxed me with RSD because of all the nerve damage. The pain from that has been driving me nuts, but my MD doesn't want to treat it until all the swelling is gone (6-8 months down the road). So I am trying to manage things on my own.
My question: Is it normal to still need pain meds this far along? I've never had a severe injury like this and I don't really know what to expect. I have been using Percocet since April, and am down to just half a pill at night if I need it. I don't use it every night but am frustrated because I can't get off it altogether. Perhaps it's just too soon?
My MD said he wanted me to stop taking it, although I'm at very low risk for addiction. He said use Aleve instead. I tried and Aleve does nothing for the nerve pain. The Percocet doesn't knock it out completely either, but at least I can sleep through it. I would appreciate any input---thank you!
3 Replies |Watch This Discussion | Report This| Share this:First Time Posting Here--Help?Hi Everyone,<br />I need some input, please! Back in April I broke my lower leg and my ankle (5 bones total). I needed four hours of surgery to put me back together---I had to have bone grafts because I shattered three inches of my tibia (along with the rest of the bones). After 13 weeks in a cast, I "graduated " to a boot and have now started PT. THe PT is tough, but I am dealing with it.<br /><br />Both the PT and my MD have dxed me with RSD because of all the nerve damage. The pain from that has been driving me nuts, but my MD doesn't want to treat it until all the swelling is gone (6-8 months down the road). So I am trying to manage things on my own.<br /><br />My question: Is it normal to still need pain meds this far along? I've never had a severe injury like this and I don't really know what to expect. I have been using Percocet since April, and am down to just half a pill at night if I need it. I don't use it every night but am frustrated because I can't get off it altogether. Perhaps it's just too soon?<br /><br />My MD said he wanted me to stop taking it, although I'm at very low risk for addiction. He said use Aleve instead. I tried and Aleve does nothing for the nerve pain. The Percocet doesn't knock it out completely either, but at least I can sleep through it. I would appreciate any input---thank you! <img src="http://img.webmd.com/community/images/smile.gif" align="top" border="0">
Peter Abaci, MD responded:
RSD (Reflex Sympathetic Dystrophy), also sometimes called CRPS (Complex Regional Pain Syndrome), can be a very challenging pain syndrome to manage. If this problem could be taking place in your particular situation, then I would strongly recommend that you get treatment for it right away, as opposed to waiting several months "until after the swelling is gone." Physical therapy is an important part of treatment, so the good news is that you have started that process, but make sure that you discuss RSD with your PT so they can best help you with that.
RSD is a clinical diagnosis and the symptoms may include an intense burning pain, sensitivity of the skin, swelling, color changes, temperature changes, and stiff joints. The hallmark of treatment is to get the involved extremity as functional as possible as soon as possible. In addition to rehabilitation work, other treatments that can help include nerve blocks, medications, and psychological treatment if needed. Talk to your PT about doing some desensitization modalities and how to use a mirror box.
Traditional pain medications like Percocet can help with things like pain after PT, but there are also nerve medications that can be tried to decrease symptoms, as well. I suggest that you talk to your doctor about referring you to a specialist who can help provide these various types of treatments.
RSD is a clinical diagnosis and the symptoms may include an intense burning pain, sensitivity of the skin, swelling, color changes, temperature changes, and stiff joints. The hallmark of treatment is to get the involved extremity as functional as possible as soon as possible. In addition to rehabilitation work, other treatments that can help include nerve blocks, medications, and psychological treatment if needed. Talk to your PT about doing some desensitization modalities and how to use a mirror box.
Traditional pain medications like Percocet can help with things like pain after PT, but there are also nerve medications that can be tried to decrease symptoms, as well. I suggest that you talk to your doctor about referring you to a specialist who can help provide these various types of treatments.
Report This| Share this:First Time Posting Here--Help?RSD (Reflex Sympathetic Dystrophy), also sometimes called CRPS (Complex Regional Pain Syndrome), can be a very challenging pain syndrome to manage. If this problem could be taking place in your particular situation, then I would strongly recommend that you get treatment for it right away, as opposed to waiting several months "until after the swelling is gone." Physical therapy is an important part of treatment, so the good news is that you have started that process, but make sure that you discuss RSD with your PT so they can best help you with that.<br /><br />RSD is a clinical diagnosis and the symptoms may include an intense burning pain, sensitivity of the skin, swelling, color changes, temperature changes, and stiff joints. The hallmark of treatment is to get the involved extremity as functional as possible as soon as possible. In addition to rehabilitation work, other treatments that can help include nerve blocks, medications, and psychological treatment if needed. Talk to your PT about doing some desensitization modalities and how to use a mirror box.<br /><br />Traditional pain medications like Percocet can help with things like pain after PT, but there are also nerve medications that can be tried to decrease symptoms, as well. I suggest that you talk to your doctor about referring you to a specialist who can help provide these various types of treatments.
angelswife replied to Peter Abaci, MD's response:
Thank you for answering---I appreciate it! You have described everything that's happening with me. I have been trying to manage this myself, and it's been frustrating to say the least. My MD is reluctant to treat this aggressively "so soon"; and my Ortho has made light of it, probably because some of the damage occurred during the surgery. I will call and ask for a referral.
I have been doing some desensitization stuff, but slowly, as it drives me up a wall....I have never heard of a mirror box, but will ask my PT when I see him Saturday. Thanks again for all your help.
I have been doing some desensitization stuff, but slowly, as it drives me up a wall....I have never heard of a mirror box, but will ask my PT when I see him Saturday. Thanks again for all your help.
Report This| Share this:First Time Posting Here--Help?Thank you for answering---I appreciate it! You have described everything that's happening with me. I have been trying to manage this myself, and it's been frustrating to say the least. My MD is reluctant to treat this aggressively "so soon"; and my Ortho has made light of it, probably because some of the damage occurred during the surgery. I will call and ask for a referral.<br /><br />I have been doing some desensitization stuff, but slowly, as it drives me up a wall....I have never heard of a mirror box, but will ask my PT when I see him Saturday. Thanks again for all your help. <img src="http://img.webmd.com/community/images/smile.gif" align="top" border="0">
annette030 replied to Peter Abaci, MD's response:
Angelswife,
I agree with our good doctor, please see a doctor who specializes in RSD (CRPS) as soon as possible. I have read many times that the sooner treatment is started the better off you are.
As far as the pain meds go, talk to the RSD specialist and ask him what kind of meds might help at this point. Then do your own research and discuss it with your surgeon. In my opinion, and in my own experience with a neurosurgeon after spinal surgery, surgeons are not trained in pain management, they always want you off of opiates as soon as possible. See a doctor who is trained and experienced in pain management.
Take care, Annette
I agree with our good doctor, please see a doctor who specializes in RSD (CRPS) as soon as possible. I have read many times that the sooner treatment is started the better off you are.
As far as the pain meds go, talk to the RSD specialist and ask him what kind of meds might help at this point. Then do your own research and discuss it with your surgeon. In my opinion, and in my own experience with a neurosurgeon after spinal surgery, surgeons are not trained in pain management, they always want you off of opiates as soon as possible. See a doctor who is trained and experienced in pain management.
Take care, Annette
Report This| Share this:First Time Posting Here--Help?Angelswife,<br /><br />I agree with our good doctor, please see a doctor who specializes in RSD (CRPS) as soon as possible. I have read many times that the sooner treatment is started the better off you are.<br /><br />As far as the pain meds go, talk to the RSD specialist and ask him what kind of meds might help at this point. Then do your own research and discuss it with your surgeon. In my opinion, and in my own experience with a neurosurgeon after spinal surgery, surgeons are not trained in pain management, they always want you off of opiates as soon as possible. See a doctor who is trained and experienced in pain management.<br /><br />Take care, Annette
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