Left consultant feeling confused - Reflex Sympathetic Dystrophy Message Board

knee · 05-01-2009, 11:08 AM

Hi! I fell badly when skiing in February and partially ruptured my acl as well as damaging some cartiledge. I had an arthroscopy 3 weeks later to diagnose what I had done and all these weeks later I still can't bend my knee past 90 degrees without being in excruciating pain - bad enough to make me cry! (don't do that often now I'm 41!)

I went to my consultant today and he said that there is absolutely no reason for my knee not being able to bend and that I may have RSD - that the physio I have been doing has not been sufficient and that I have to work through the pain to get my leg working again... have had a tentative go at bending the knee further but it really just won't go!

It is still puffy and swollen but although it is sensitive to the touch it doesn't hurt much except when I try to bend or straighten it fully...

Can anybody help me? Do I have to get somebody to bend the knee for me and work through the pain or are there other ideas to solve this problem?

Hope you can help!

Gaollan · 05-01-2009, 01:06 PM

First, if you have RSD, you should absolutely not "work through the pain". This is dangerous because not only will it cause more pain, it could easily cause the RSD to become worse very quickly. That is just my opinion based on personal experience and that of other people who have also been in PT. It is a fact that aggressive therapy is not good. No pain no gain is NOT something that applies to us. Therapy should be slow and gentle.

The first thing that should be done immediately is to refer you to a pain management doctor. These doctors are anesthesiologists who do blocks and provide medication. Blocks should be done as quickly as possible. There is a small window of time after the first symptoms of rsd appear to possibly get it into remission. That is certainly not always the case. RSD is a very individual disorder because all of our bodies work differently.

Usually with a problem like yours, being unable to fully bend or flex a joint, a pain doc will do a block and send you to pt right after so manipulate the joint without causing you a great deal of pain. Have any MRI's been done? I know from others that scar tissue can cause a problem with joint mobility.

Despite what many "newbies" to rsd read, the pain doesn't have to horrible beyond everything 24/7. Even with those of us who have had it a few years, our pain fluctuates all the time. This is the nature of RSD. I'm sorry you've had those 3 letters uttered to you but it's not the end, only the beginning. With quick and proper care, I can hope you'll be one of the lucky few to go into remission.

Feel free to ask any questions you like. This is the only way to learn.

Hugs,

Karen

feelbad · 05-03-2009, 09:42 AM

i just wanted to mention one other possible thing here that this just 'could' be? there is a condition called "charcots joint" that can actually mimic alot of the same symptoms as RSD. this is what they first thought i had in my knee before i finally got a proper RSD Dx from my amazing ortho. do you have any level of 'heat" in that knee that is higher in temp than surrounding areas?

this condition only shows up in wieght bearing joints such as the hip, knee, ankle or foot areas. its just something i do think you may also want to research as a "possible". you just appear to have alot of the same symptoms, thats all. i do wish you luck with this. please keep us posted. Marcia

popstarrdiva · 05-04-2009, 09:07 PM

Ok. So I need to tell you my story. Fall 06 tore my quad above the knee, but didn't know for a couple of months. Surgeon put me in a Zimmer cast to give my muscle time to heal. One month later came out of the cast + could not bend my knee AT ALL.....like one peg leg. I could tell the surgeon was scared. Just told me to go to physio and keep "bending" it. Went throught excruciating pain getting my leg to bend. Swelling wouldn't go away etc etc. In hindsight, not sure if RSD started there.
Jan 08, sprained my foot. Went dead person cold and diagnosed with RSD. I just wanted to warn you to get proper blocks + pain meds because bending your leg will kill with or without RSD. Most pain I have ever felt. Not to scare you, but please have a lot of pain meds in place before attempting. I have a lot of empathy for you and I am sooooo sorry you will have to endure this. I would also suggest placing a tens on your low back to also try to block pain signals to your brain during bending. DO THIS SLOWLY + CAREFULLY. It took me a few months and I started from 0 degrees bendability. I almost cried when I hit 90 degrees.
I hope you learn something from my experience + please Im me privately with any questions ANYTIME!!! I so hope to help you through this. It was a terrible time for me.
Take care and I hope that I haven't scared you too much. I just want you to have all the info.

knee · 05-05-2009, 06:57 AM

Thank you for your replies!

Even though there are some pretty stark messages I would rather have information so I can deal with this in an informed way - and it is good to know there are people who can understand what it feels like!

I am just going into work to plan my return with my boss (I am a primary school teacher) and have made an appointment with my GP tomorrow. My consultant has changed my physio from a local clinic to the hospital so he can keep a closer eye on me and I have a session on Thursday morning so I'm planning on asking for some strong pain meds tomorrow to help me cope on Thursday.

I haven't tried TENS so will ask my GP/physio to help with that - thanks for the tip!

Are you fully mobile now Popstardiva? It has taken me since my accident to reach 90 degrees to so I know what you mean about it being a relief!!! However, it is still only 90 degrees - I can't kneel or crouch (which is going to make my job tricky) but also stops me doing the garden properly (which I love) and just makes me feel so immobile and cranky...

I have been trying really hard to just gently, very gently, extend my movement over the weekend but it just won't go! Hoping the new physio will have some sort of magic

Thanks again for emailing - what did we all do before forums?!