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Reflex Sympathetic Dystrophy (RSD) (CRPS) Message Board
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Old 02-14-2004, 02:09 AM   #1
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Worried that I have RSD in foot...some questions

Hi everyone.

I have an area of fat pad atrophy in the ball of my left foot that I injured back in November. I am noticing more atrophy as the weeks go by. However, this atrophy started to occur following an injection of cortisone on the top of my foot, and the area of atrophy is on the bottom of the foot under the injection site. It's been over a month since the injection, and the fat pad atrophy is spreading and it is red where the atrophy is located. However, at this point, I am in no pain.

I don't know if a cortisone shot can cause atrophy in the fat pad of the ball of the foot. Does anyone know?

Also, do any of you who have RSD (especially those people with RSD symptoms in a foot) have atrophy of fat tissue occurring?

Is there anything I can do to stop the progression of the atrophy? Is there a certain type of doctor I should be showing this fat pad atrophy to? My podiatrist already made a note of it, but didn't offer any help.

Thank you for any replies.

 
Old 02-14-2004, 06:53 AM   #2
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Re: Worried that I have RSD in foot...some questions

Hi Sealover,
I don't think you should assume you have RSD because of the fat pad atrophy. I typed 'cause of foot fat pad atrophy' in my search engine and it brought up a bunch of sites for that condition alone and none in conjunction with RSD. A lot of them recommended using gel pads to cushion the area.

Pain and burning are hallmark signs of RSD along with temperature changes in the affected limb and mottled discoloration. I'm not saying that you can't have RSD without pain, but it seems unlikely. I really hope that it is not RSD. Have you talked to your doctor about physical therapy?

I hope your foot gets better!

Julie

 
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Old 02-15-2004, 12:22 AM   #3
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Re: Worried that I have RSD in foot...some questions

Hi Julie,

Thanks for your message!

What search engine did you use?

To answer your question, I have been going to physical therapy since about 2-1/2 months ago around the time of my injury of banging the dorsal side of my toes really hard into metal by accident. At first, my forefoot was hypersensitive to touch, it was swollen, it hurt, it felt cramped, my 2nd toe tingled, I could not move my toes and I could not walk due to pain. Through physical therapy and cortisone injection, I was finally able to move my toes, and they seem to have regained full movement. I have no swelling in my forefoot, no major crippling pain, but the 2nd toe is a bit hypersensitive (I have nerve compression there), if I press on the base of my 2nd toe on the plantar side it hurts, and the area where the fat pad atrophy is located is red and has become more uncomfortable this weekend with a slight burning sensation, but that area is not too painful. I have no other symptoms. Two podiatrists said I may have RSD, but from what I've read here, a lot of you are in a great deal of pain, whereas I was in a lot of pain with all the symptoms mentioned above, but the pain has mostly gone away, unless I am on my feet for a while.

Is it possible to have RSD that goes away in a few months because of early treatments?

A lot of things about RSD are confusing to me...

 
Old 02-15-2004, 04:34 PM   #4
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Re: Worried that I have RSD in foot...some questions

Hi Sealover,
You're not the only one confused by RSD!! Yes, early intervention can definitely put RSD into remission. That's why most of us here encourage newbies to not delay in getting treatment.

It's so hard to know just by your description whether or not you have RSD, and anyway, I would never presume to know whether or not somebody has RSD. But since a couple of doctors have mentioned it as a possibility, I would keep a close watch. If it gets worse or if more symptoms appear you should probably see a pain management doctor who treats RSD and get his opinion.

Best wishes,
Julie

 
Old 03-10-2004, 10:18 PM   #5
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Re: Worried that I have RSD in foot...some questions

hi sealover,
I have RSD in my left foot. I just noticed this week that I have fat pad atrophy. Mine is in my heel though. Feels like I am walking on the bone. Going to have my physical therapist look at it Friday. I looked it up and it sounds like the only thing you can do with it is wear pads or have orthodics made for your shoes. I sure hope you don't have RSD. Your podiatrist should know how to treat it(fat pad atrophy). And cortisone can cause it! I had a lidocaine/cortisone shot in my sural nerve near my heel and I wonder if that might have caused it. Due to one of my foot surgeries they drilled a hole in my heel and I thought that was what was hurting. I wish you luck and keep us informed.
Rose

Last edited by rosarally; 03-11-2004 at 04:29 PM.

 
Old 03-11-2004, 07:49 AM   #6
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Re: Worried that I have RSD in foot...some questions

It is very early in the morning and I am all drugged up so maybe you have already said this but I will ask anyway.

Has it been just a few days since the redness has been there without any(or much) pain? If so you may not want to rule out RSD just by there not being pain in that area yet. The first time my RSD showed up, every joint/knuckle was purple and my skin was blue, I was also extremely weak. This was for almost a full week before I ever had any pain come on. By the end of the week, I had full body RSD and wasn't diagnosed for 4 months later. But finally went into remission and it didn't relapse until 7 years later. -- That's why I'm here now!

So catch it early. It's great you're already in therapy so you won't really have to adjust your lifestyle if you do have RSD! I recommend going to see a neurologist who treats RSD. It's not likely your podiatrist knows enough about RSD to diagnose you.

Kerri

Last edited by KerriBerry253; 03-11-2004 at 07:50 AM.

 
Old 03-12-2004, 01:01 AM   #7
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Re: Worried that I have RSD in foot...some questions

rosarally,
It's possible the cortisone injection caused your fat pad atrophy. I don't think that there is anything that can be done except to make sure you have a good heel pad in your shoes, like one of those silicone heel pads. Please let us know what your doctor says about your heel.

kerri,
I'm so sorry that you have RSD again. Do you know what caused your RSD to reappear?

An update on my foot injury/possible RSD/CRPS...

I went to see another podiatrist (I have another appointment with her today), and she said that the fat pad atrophy on the ball of my foot was caused by the cortisone injection my first podiatrist gave me. I'm disappointed that that podiatrist did not warn me that in some cases cortisone can cause atrophy to the plantar fat pad.

So this new podiatrist said she doesn't think I have RSD now and that I may have had it, but it went into remission. She wants me to see a neurologist, so I still have to make that appointment. She mentioned that I may need to take Neurontin. I have no idea if this podiatrist is "qualified" to diagnose RSD/CRPS.

Some of my current symptoms in my injured left foot are fat pad atrophy in the ball of my foot beneith the cortisone injection site & pain in this atrophied area if I'm on my feet for a while, as well as some hypersensitivity in my 2nd toe (caused by nerve compression) that gets worse if I'm on my feet for a while, rarely I will get a shooting pain in the 2nd toe. I often notice a deep red color of discoloration on the bottom of my foot on the plantar side of my big toe and also on the ball of my foot in an area spanning from my big toe to my 3rd toe; the rest of my foot is normal colored. What is strange is that the discoloration is not present 100% of the time, so I don't understand why this is happening. And one night I noticed that my heel, plantar side of my big toe and ball of foot from the 1st to 3rd toes turned a black and blue color. I noticed a few times that my left foot felt slightly cooler to the touch than my right foot, but other times they feel the same temp. After being on my feet for a while, my left forefoot starts hurting me (last night after cleaning the house, I could barely walk on that foot).

Since my left foot became injured, I developed burning pain in the ball of my right foot beneith the 2nd and 3rd-4th toes that radiates into these toes. I've never had problems with my right foot before, but I think the burning is related to a couple of things: the first podiatrist pressing really hard into the base of my toes on my right foot and bearing more weight on my right foot when I could barely walk with my left foot during the first month of the injury.

My physical therapist all of a sudden told me that I will be doing all of my physical therapy exercises at home, instead of at the clinic. I am only receiving hydrotherapy and manipulation of my toes by the physical therapist. It's very difficult to do all of the exercises at home without supervision and without the equipment, but my physical therapist won't budge in her decision.

So that is really all that is happening for now. I still don't know whether or not I have CRPS.

You all are in my prayers.

Last edited by sealover; 03-12-2004 at 01:11 AM.

 
Old 03-12-2004, 06:25 AM   #8
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Re: Worried that I have RSD in foot...some questions

Sealover,

No idea why it relapsed. I was reading some recent writings by the doctor who originally diagnosed my RSD(RND) at 15. Dr. David Sherry. He said the studies have shown that 92% of children with RND who go through with (his) in-patient physical therapy treatment don't relapse within 5 years. Which was true for me, but then I relapsed within 7! Darnit! He needs to find the button to push to extend that '5 years' to 50.

Last edited by KerriBerry253; 03-12-2004 at 06:32 AM.

 
Old 03-12-2004, 07:26 AM   #9
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Re: Worried that I have RSD in foot...some questions

Hi Sealover,
It sounds like you've made progress in some ways, yet you are still in the dark in other ways. That's so frustrating! I'm glad you'll be seeing a neurologist. Please let us know how that visit goes.

KerriBerry - a 50 year remission sounds great to me, too!

Take care,
Julie

 
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