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Reflex Sympathetic Dystrophy (RSD) (CRPS) Message Board

Reflex Sympathetic Dystrophy (RSD) (CRPS) Board Index

Hi everyone. This is my very first post to the RSD message board, and the following is a long post to describe my injury & symptoms. I would really love your feedback on my situation.

Two different podiatrists told me that I may have RSD as a result of a left foot injury, but perhaps I don't have RSD at all. I never heard of RSD before this, and I have done some research online about RSD and was saddened by what I read and scared at the thought that I may have RSD.

My story: In November 2003, as I was getting out of the shower, I accidentally banged (really hard) the dorsal side of my toes on my left foot into the metal tracking for the shower doors. The pain was extremely excruciating: I immediately felt pain in my toes and in the ball of my foot, I noticed a severe uncomfortable sensation in the digital nerve running up my 1st and 2nd toes, I could not move my toes, and my forefoot was hypersensative to light touch. I could not bear weight on that foot because of the pain (all I could do was limp). The ball of that foot swelled some, my toes swelled a little bit (which probably affected my ability to move my toes), and my entire foot felt tight and cramped. (I want to note that I had banged the 2nd toe on that same foot 10 years ago on a metal object, which caused the nerve in that toe to tingle when the base of the toe on the plantar side of the foot was tapped, but this healed this past September.)

Anyway, I visited my family doc right away, and he said that the injury would heal in 2 weeks (yeah, right!). He prescribed Ibuprofen and crutches. I used the crutches or limped for a week before visiting my 1st podiatrist. The podiatrist took X-rays which came back normal. The podiatrist stated that I may have a neuroma and may have RSD/CRPS. The podiatrist gave me a cortisone injection in the 2nd intermetatarsal space on the dorsal side of my foot and prescribed Bextra (anti-inflammatory med.) and physical therapy. I began walking soon after the 1st cortisone injection & with the start of physical therapy, but I still had pain in areas of my forefoot, I still experienced some hypersensitivity/tingling on the plantar aspect of my 2nd toe, and I had some hypersensitivity in my forefoot which eventually went away completely. The podiatrist ordered an MRI, and the results showed "Focal increased signal noted in the soft tissues dorsal to the proximal phalanx 1st and 2nd toes may be secondary to the mild prominence of the dorsal digital artery versus a ganglion especially in the great toe where it is difficult to establish a continuity with the remaining vessel." So the MRI did not show that I have a neuroma. But the podiatrist thinks the digital nerve in the 2nd toe is compressed because of my symptoms. This podiatrist gave me another cortisone injection in the 1st intermetatarsal space on the dorsal side of my foot a month ago, but the tingling/sensitivity on the plantar side of my 2nd toe did not go away after this injection.

I went to a 2nd podiatrist for another opinion last week, and he independently suggested that I may have an entrapped nerve in my 2nd toe and that I may have RSD. He noted an area of fat pad atrophy, but not major atrophy, in the ball of my foot below my 1st & 2nd toes, but I wonder if that atrophy may be caused my the cortisone injection; he also noted abnormal redness of the skin in this particular area, though there is no swelling. I noticed that some of the fat pad in my big toe on this foot is less than it used to be. I reported to him that I have pain in the ball of my foot in the area where there is abnormal redness, I have hypersensitivity/tingling on the plantar side of my 2nd toe, and I have trouble being on my feet because of the pain in the ball of my foot and at times in my 2nd toe. This 2nd podiatrist ordered X-rays of the left foot to make sure that my bones weren't starting to show osteoporosis due to RSD, though the X-rays came back totally normal.

With physical therapy, beginning in Nov. 2003, the swelling in my foot disappeared, I gained mobility/strength back in my toes, and I could walk better within the 1st month. I am still going to physical therapy. My physical therapist started my 1st of 6 treatments of Iontophoresis last Thursday, and this weekend is the first time that I am able to walk without much pain and without any limping.

I currently still have some abnormal redness of the skin in the ball of my foot below my 1st and 2nd toes (but seemingly not as much redness as last week) with a bit of fat pad atrophy in that area, as noted above. I still have hypersensitivity/tingling in the 2nd toe, but not as much as I did last week. The pain in the ball of my foot below my 1st & 2nd toes has improved greatly since my 1st Iontophoresis treatment last week.

So what do you all think based on your knowledge and experiences with RSD: Might I have RSD which was been helped by immediate treatment with physical therapy, anti-inflammatory meds, and cortisone injections. Or was I misdiagnosed, in that I simply suffered injury to the tissues in my forefoot and nerve injury to my 2nd toe (remember, I banged the dorsal aspect of my toes very hard into the metal tracking and the symptoms were immediate).

Any opinions will be greatly appreciated. By the way, I want to note that I have read many of your own experiences with RSD, and I hope & pray that you all find relief for your pain and suffering. RSD seems to be a poorly misunderstood disorder, and that is unfortunate.
Hello Sealover,
Welcome! I have to agree with Edna that it is a little premature to label your symptoms as RSD - which is a good thing! Even if it is RSD you did the right thing by getting into PT right away as that is the first line of defense against it. I'm so glad to hear you have had some improvement even though the progress has been a bit slow.

It is good that you are educating yourself about RSD in case that is what it is. I know that a lot of the information on the Internet can really frighten a person (it did me at first), and a lot of it is conflicting or controversial, but you will be better prepared to fight the RSD if you are educated about it. This board has been an invaluable resource for me.

Once again, welcome, and please keep us up to date with your progress.


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