Discussions that mention kenalog

Reflex Sympathetic Dystrophy (RSD) (CRPS) board

Thanks so much for the replies. Laura, that's great that your pain has lessened and that you have more strength and balance...like you said, exercise helps a lot. Marcia, I'm so sorry to read about all of the pain you have and about the atrophy in your hand. Have you had a nerve block yet?

I am perplexed as to whether my symptoms are due to steroid injections and irritation of the small nerve fibers from my injury or if my symptoms are related to RSD.

It's so hard to know what to believe when several doctors have told me that I probably don't have RSD, that my symptoms are due to fat pad atrophy caused by steroid injections and to nerve irritation from the injury and from steroid injections. Then one pain management doctor spends little time going over my history and barely examining my foot and says I have RSD. I'm not sure if I want this pain doc to treat me because he didn't do a comprehensive examination, plus, my foot didn't have the actual appearance of what the physical manifestations of RSD are, except for fat pad atrophy.

I have had a total of 2 steroid (Kenalog) injections into the top of my foot following my injury. I have done a lot of research into steroid injections, and it is actually possible to get fat pad atrophy from just one steroid injection, especially if the needle is accidentally inserted close to or into the superficial fat layer. I noticed the fat pad atrophy occurring soon after the steroid injections directly beneath where the injections were given. The podiatrist hit a nerve the second time he gave me a steroid injection. What is not good is that if someone has RSD, then needles probably shouldn't be inserted into the area of injury because it can exacerbate the RSD.

Anyway, I looked at my toes again last night, comparing the toes of the bad foot to the good foot. Looking at the toes from the top of the foot, they are the same for both feet, however, looking at the toes from the bottom of my feet, the fat padding on the tips of the toes on the bad foot are smaller than the fat pad on the tips of the toes on the good foot. So some of the fat pad on my toes on the bad foot has atrophied.

I think the fat pad atrophy could be a combination of damage from steroid shots and from nerve damage. I don't have any numbness/loss of feeling in my foot, and the severe hypersensitivity to touch has gone away soon after I started PT in 2004.

I don't know what specific nerves were hurt in my foot. Dr. Hooshmand wrote about "water-shed zones", and that these are the areas that are more susceptible to develop RSD. The specific area of my foot that banged into metal is a water-shed zone. Lucky me! That is where the small C nerve fibers are located.