sealover

Hi everyone,

I've been told that I do not have RSD, yet I was told by a PM doc that I do, in fact, have RSD, though that PM doc did NOT do a thorough examination and didn't answer any of my questions and only cared about having me come back for sympathetic nerve blocks, so I don't trust his credibility. It's been over 3 years since my left foot injury, and there is no true consensus as to whether or not I have RSD. A doc recently said that I don't have RSD, that he's had patients who have dropped turkeys and drawers on their feet (I accidentally hit the top of my foot on something), and they ended up with chronic nerve pain, but it's not RSD. He said that some doctors use the word RSD loosely as a diagnosis. Yet another doc recently said that I have a pain syndrome, but this doc was very rude at my evaluation and told me I am malingering and much of this is in my head. Ugh!

My injured foot has tolerable to severe pain mostly in the forefoot/ball of foot, but I get arch soreness and some heel pain after being on my feet. I have fat pad atrophy in the ball of my foot due to steroid injections following my injury, and that steroid is known to cause muscle atrophy, too. I have pain every day, most of the day, but it does subside with rest (I wake up with no pain, but pain starts after I begin to walk). It just so happens that the painful area is where I bear most of my weight into, so that doesn't help at all. The pain in my forefoot feels like bone pain and perhaps muscle and nerve pain. I have a lot of soreness in my forefoot and in some of my toes after being on my feet. Sometimes, I get swelling in my ankles, but I wonder if that has to do with me sitting a lot. I don't have any awful burning pain or hypersensitivity or lack of feeling. There is no swelling of my foot, no sweating that I can notice, no skin changes, no overall discoloration, no nail changes, no spread of the area of pain. However, when I stand in the shower and place all my weight into the bad foot when I try to shave the other leg while in the shower, I get some purplish discoloration in a couple of areas of my foot (I don't know what this is caused by), yet the rest of my foot is pink in the shower. I noticed on a few occasions in the winter that my left foot felt slightly cooler than my right foot, but most of the time, I don't sense any temp changes between my two feet. When I first injured my foot, my foot immediately had hypersensitivity and tingling, but that went away.

My forth metatarsal is killing me , and the pain goes into the forth toe. The forth toe has become a bit thinner and it sort of lays on its side when I'm standing, like it's too weak...I don't know what is wrong with that toe, and I haven't gotten any answers from doctors. It seems my toes on the bad foot have become somewhat weaker. I know my arch is weaker, since I can feel the insole of my shoe pushing into that arch more than on the arch of the good foot.

Does anyone have thinning of the fingers or toes due to RSD? Can RSD cause a toe or finger to become thinner or to atrophy? What is the difference between atrophy and dystrophy?

Anyway, I had regular x-rays done recently, and the orthopedic surgeon said the bones are normal, yet the podiatrist said I have osteoporosis in my feet. So no consensus on my x-rays, therefore, I have to find yet another doctor to look at my x-rays. I had x-rays last year, and that orthopedic doc said they were normal. So I don't know who to believe...are my bones normal or do I have osteoporosis? I just had a bone scan again, and the results are normal. I've never had a bone density test.

What kind of doctor can tell me for sure with 100% certainty whether I have RSD or not? I don't know what to believe anymore. Most of the doctors I've seen said I don't have it, but then when one doctor mentions RSD, I start worrying all over again. I've not had any nerve blocks.

By the way, I use capsaicin cream on my bad foot, and the burning sensation the cream creates when I first start using it is actually soothing as it helps cover the bone/nerve pain. I actually love it when the capsaicin provides a burning sensation...the burning sensation does not damage or actually burn my skin. Many people cannot tolerate the burning sensation. But when used as directed for at least a few weeks at 3-4 times per day, the burning sensation starts to cease. I think capsaicin is made from the pepper plant, and if used on a regular basis, capsaicin depletes Substance P which, in turn, helps reduce pain. It's not a miracle pain reliever for my foot, though, because if it was, I wouldn't be here complaining of pain.

I've been on this board many times to read posts and to ask questions to get a better understanding of RSD. It's so confusing. The steroid that was put into my foot can cause a lot of damage to soft tissue, so being that I had steroid injections complicates things a bit.

Thanks so much for any help and info.