CRPS diagnosed while my wrist is still fractured - is this possible?

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Hi,

I broke my right wrist (radius) 8 weeks ago and today i was diagnosed with crps, despite my wrist (radius) still being fractured. I was taken out of my cast at 5 weeks with no examination or x-ray and told my wrist was healed. I returned to A+E 9 days later after trying to carry out suggested wrist exercises because i was still in severe pain. After an examination and x-ray from an A+E doctor i was told my wrist was infact still broken and i shouldnt have been doing any of the excercises. I was put back in a cast and told to attend the fracture clinic 2 days later. I attended the fracture clinic and was yet again taken out of the cast and was told by a consultant i had osteoparosis at 27years old, and this is why my bone had not healed (they refused to consider the possibility that it hadnt healed because i was without a cast and had being moving it as suggested). I requested a second opinion and was reffered to a different consultant which i attended today. This particular consultant had disagreed completely with the osteoparosis diagnosis, so much so he diagnosed me with CRPS. This has left me very confussed as everything i have researched has indicated that CRPS occurs after a Fracture has healed. 

Is this possible?

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  • Posted

    Hi Kelly

    I hope this is helpful, after a fall on to my wrist, I was told I had a fracture, I got put into a temporary cast, the next day I had to go back to the fracture clinic, I had already been diagnosed with CRPS in my ankle three years prior, the fracture consultant advised me to have the cast taken off as he said my wrist could turn into CRPS also, just by being put into a cast?

    I wish you a speedy recovery!

    Sincerest regards Carol

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    • Posted

      Hi carol

      Thanks for the reply. Did your CRPS in your ankle occur after your ankle had healed? I am assuming you had a fractured ankle to begin with. I only ask as i am struggling to see how they can say the pain is due to CRPS when i still have a fracture.  

      Thanks Kelly

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  • Posted

    I was diagnosed with CPS at 12 wks ,I fractured by tibia x2 and fibia just below the knee .I was in extreme pain from the outset which had only gradually reduced to 7/10 .A Scintigramme confirmed this ,even I could see the difference on the images .the pain is now down to 2/10 sometimes I have none at all and after physio it increases .Mine was classic with crocodile skin and badly swollen from knee to ankle .I now have a TENS machine ,physio still twice a week and Lyrican tablets .At the beginning was taking morphine and paracetamol and tramadol but now down to 100 mg of paracatamol x2 a day .Hope this helps Marion
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  • Posted

    Hi Kelly sorry to hear about your wrist fracture and hope you are not in too much pain.  Did you have any surgery I.e. Plate fitted? When the first cast was fitted how did your arm and wrist feel? Was it very painful e.g. Did you feel as if your arm and wrist was going to burst and or did you feel as if something was pinching your wrist? Your first consultant has diagnosed you with osteoporosis, have you had a recent Dexa scan?

    If you have not had this scan then it would be impossible to establish the condition of the bones. For information crps occurs as the fracture is healing I.e. Whilst the cast is still on.  In my opinion I think that casts are responsible for crps.  I myself experienced a comminuted distal radius and after surgery was put in a cast for several weeks.  During that time I experienced unbearable pain however I just thought that this was normal as I have never broken a bone before so didn't know what to expect. I even mentioned the pain to my consultant and he informed that it was to be expected as it was a really bad break. However I really don't think that this pain was normal. After getting the cast removed my arm, wrist and hand were badly swollen and extremely sore and stiff. I was told not to start Physio until 6 weeks later however as seen as I started Physio I was diagnosed with crps. Symptons of crps are swollen hand and fingers, hand appears to be shiny and mottled looking, hair growth (I have now got a black hairy left hand!) hand will be hypersensitive e.g. You can actually feel cold air on   the hand, also if you put your hand in hot water it feels as if it is scalding. Also have difficulty if sleeve of garment is sitting on wrist as it feels so uncomfortable. Referring back to your exercises while your arm/wrist was in a cast it is highly unlikely that you displaced the bone taking into account the only thing you could move were your fingers!  If the bone is still not healed then I can't understand why they have just left it as it will require surgery. The consultant who diagnosed you with crps, has he prescribed you with any meds? First of all if the diagnosis of crps is correct then this gives you a heads up as the sooner it is treated then the more effective this treatment will be. You will require intensive Physio for a number of months to break the crps cycle. Currently you can't move wrist and figures because it's too painful but this will only worsen if you don't Commit to Physio. I hope this helps in some way and please let me know if you have any more questions. 

     

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    • Posted

      Hi,

      No i didn't have surgery on my wrist, consultant said that would make it worse as i would damage the soft tissue in my right hand. When i reffered to the possible movement of the bone while doing wrist excercises, i was referring to week 6 of the fracture when it was taken out of the cast and i was therefore moving my full wrist not just my fingers. 

      I had the cast removed at week 4 and replaced on the same day by A+E due to the tight stiff burning sensation that you described. The first consultant that diagnosed the osteoparosis did so by looking at my x-ray, i have not had a dexa scan. The second consultant that diagnosed CRPS a week later hasn't prescribed me any meds as yet. He has reffered me to a pain medication specialist and a physio, although said i could wait up to 6 weeks for an appointment.

      Are you over CRPS? Or are you still suffering with it? Either way how long have/did it affect you?

      Thanks

       Kelly

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    • Posted

      Hiya kelly 

      i hope you aren't feeling too bad 

      To be on the safe side I would request a Dexa scan to rule out the possibility of osteoporosis as if you do have this then you will need to take medication I.e. Calcium tablets. Taking into account your tender age and if you are active then it is highly unlikely that you do have osteoparosis 

      The bone itselft starts the healing process straight away and its expected that the bone would be fully healed within 4 to 6 weeks if the fracture requires no surgery.  Therefore it is highly unlikely that you have damaged this by manipulating your hands and fingers at week 6.

      After surgery I had my cast removed approximately 5 to 6 weeks later and was then told not to have any Physio for 6 weeks as it was badly swollen and sore. However as soon as I presented for Physio  I was diagnosed with Crps by my Physio and a few days later at my consultants appointment and both of them referred me to the pain management clinic.

      At the consultants appointment I was prescribed Gabapentin and amitryptaline. Before this I was prescribed tramadol for the pain and was advised to carry on taking this.  So as it stands my diagnosis was confirmed only 5 weeks ago and I am expecting this condition to last for several months.  However on the good side I have heard that early diagnosis is crucial as any treatment given will be more effective. 

      I have found after after tinkering with the dosage that this has taken the edge off the pain. I have recently been told by my GP to increase gabapentin dosage and I feel that I am benefitting from this.  I am still waiting for my appointment with the pain management clinic and have just found out that there is a 12 week waiting list. As soon as I attend I will let you know what happens so you can prepare yourself with any questions/information that you may need.

      Can I ask if your consultant has prescribed you with any medication?  Taking into account that your wrist is very stiff now you will need medication to assist with the Physio. Have you had any Physio sessions? I am currently having nhs and private Physio.  However I have found that the private Physio is more hands on whereas the nhs has mainly been verbal with supporting exercise sheets.

      Since this has happened it feels surreal as it is a totally different lifestyle.  I was working full time and in the gym most evenings and at the weekend. Now I am at home, unable to work and feel as if my life has suddenly stopped. I am in constant pain and feel really down. I can't drive as my wrist is not strong enough, did have a go last week but couldn't even get the handbrake off. Seen ohs last week who advised me to have counselling. I had my first assessment this week and the clinician told me that she had real concerns for my mental health as I guess I was at rock bottom. The only thing that keeps me going is that I will recover from this in time....

      Apologies for the long response but I hope it helps in some way. Please get in touch if you have any other questions or just want to chat. Take care

       

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    • Posted

      Hello Cillasmum,

      ?I had to respond to you as I am experiencing everything you are.

      ?I'm very active - in the gym doing HIIT classes 5 times a week.  I was doing a boot camp class when I fractured my wrist.  After a manipulation of th brake didn't work, I had to have surgery to insert two K-wires.  I am 10 weeks post surgery and 6 weeks out of cast. 

      ?As soon as the cast was removed I could feel immense pain, a feeling I couldn't quite explain.  It was like the air was hurting me.

      ?I mentioned this to the consultant in my following appointment as the pain didn't subside and he diagnosed CRPS which was "all part of it".  He didn't prescribe any medication as it will just "eventually go".  I was already prescribed Ibuprofen and Co-dydramol after surgery and was told to continue taking them.  My wrist and fingers are still swollen and I have long dark hair around my wrist area which is very obvious to see.  It looks totally different to my other arm.

      ?I was referred to Physio straight away as the lack of movement in my wrist and fingers was a concern and this has helped.  I can now do palm up, palm down movement but can't flex my wrist back and forth.  My CRPS doesn't seem to be a concern to my PT but he has mentioned it most probably is hindering my progress. 

      ?One negative thing, which I am quite angry about, I mentioned to my consultant and my PT that my shoulder is hurting me.  Again... both said it's "all part of it".  After going to my GP (again) as I know somethings wrong, she thinks I've got a Rotaor Cuff Tear whcih happened when I first fell... unbelievable!!!  I'm now awaiting an MRI/Ultra Sound.

      ?I have started driving again and gone back to work part time (phased return).  I've tried to go to the gym but can't get motivated.  I feel like a totally different person, very low in mood and very tearful too!  I had an over the phone councilling session this week who advised me to see my GP as I'm showing signs of depression.  I feel like I'm on a downward spiral and don't know where/when it's gonna end.

      ?Cillamum has your doctor prescribed Gabapentin specifically for your CRPS as mine doesn't seem to be even addressing it????

      ?I can SO relate to your post so thanks SO much xxxxxx

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    • Posted

      Also... as I'm replying to an old post, how are you now? 

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  • Posted

    CRPS is chronic pain ,chronic pain is over and above the normal for the injury sustained and the pain is of long duration ie more than 6 months .Pain is to be avoided at all costs and gentle physio will be advised .I am a reluctant expert of this disease who has gradually reduced their medication from continuous and on demand morphine + paracetamol + tramadol down to 4 paracetamol per day .It could be coincidence that cast off. = CPS 
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  • Posted

    Hi Kelly

    How ru today?

    One question did anyone say to you by putting your wrist in a plaster cast can cause CRPS? When I had a fall and had a supected fracture, put into a temporary cast on being see the following day at the fracture clinic, because I had CRPS in my ankle the consultant asked me to manage in a splint and had the cast taken off so as not to develope the illness in my wrist too?

    Luv Carol

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    • Posted

      I saw my OS just this last week he recommended  that in 2 years he would take out all of the hardware in my leg ,when I mentioned the Cps he said that as it was a planned op was much less likely to occur .His reasons for taking it all out was that if I was unfortunate enough to develop arthritis in the knee he would prefer that the leg is fully consolidated before he had to a knee replacement op .Am not sure whether to pleased or not that I have a fwd thinking surgeon !
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  • Posted

    Hi Kelly,

    i have aver also been diagnosed with CRPS after breaking my wrist seven months ago.  The consultant looked at my swollen shiny arm and just said, "You should get most of your hand function back eventually and I am discharging you".  I was in such a state of shock I just went home and cried.  BUT fortunately I met the head of the hand physiotherapy unit socially and she was horrified, told me to complain as physiotherapy is the key to recovery.  So I got an appointment with another consultant who took one look and said CRPS.  He advised a carpal tunnel operation.  To be honest I think that has caused more problems than it solved - I don't recommend it.  But I have now been having physio for four months, the swelling has gone right down except when I'm tired, the hypersensitivity is still there but manageable and I am beginning to feel I am getting my life back. Go for physiotherapy and take all the painkillers you need.

    good luck!

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  • Posted

    Hi Kelly. I also broke my wrist last year and whilst in cast the pain could be excruciating. I received physio within 3 weeks and was later diagnosed with crps. I've had a dexta scan and have been told I have osteopenia. The last dray I had with consultant showed bone density in wrist improving. It's a sign of crps to have honeycomb effect bones. They can only diagnose osteoporosis by scan, if your concerned ask for a referral. Work hard at physio and try not to treat your hand as the enemy, (I know that's hard to do) hopefully if you do as physio say it will improve, try warm and cold therapy, desensitization, mirror box.
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    • Posted

      Hi Maddy,

      Would you mind if I messaged you? You are the first person I have spoken to who has the same injury, same scans etc etc and I am 4 months in and banging my head off a wall now! Thanks Kelly

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    • Posted

      Hiya kelly I'm still following this discussion so just wondered how you are? I've just sent Maddy a message on another discussion about CRPS and returning to work.

      Just to refresh I broke wrist in December, had surgery I.e. Plate and screws inserted. Then after cast removed was diagnosed immediately with CRPS. Now nearly 6 months down the road... Attended a pain management clinic where I was offered a pamidronite drug infusion which I accepted. The PM consultant stated 'Physio is key to improvement '. My progress in Physio has been extremely slow but steady. My Physio recently said 'may not be worth carrying on as progress so slow' which really worried me but the following week I enforced what the consultant had said and reminded her of my progress. To be honest I think that managers are telling staff to get people off their caseload so they can accept new referrals in order to meet targets. 

      Still on a lot of medication but I have reduced dosage as was feeling really spaced out and ended up having a fall which really shook me up, really lucky I didn't do myself serious damage. 

      Take care now

       

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    • Posted

      Hi smile

      That is awful that progress is so slow for you, I completely understand how frustrating it can be!

      I am now four months down the road and my wrist is still broken although they are stating crps and insisting on physio although the physio woman keeps trying to bend my broken wrist which isn't great. I am still waiting on pain management app and also my dexa scan app and the physiologist declined my referral which isn't great but I have a legal team on it now as I have had enough of different advice etc so I guess it's just a waiting game.

      I am the same as you in the sense that my progress is painfully slow and they are saying I may never get the movement back in my right hand Which is devastating and they are also refusing to do surgery as they are saying with crps it won't work so I am walking around with a broken wrist 4 months later, still in a splint outdoors and at night

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    • Posted

      Hi kelly Oh sounds like you're having a really difficult time. I cannot believe that you are still in a splint after 4 months?!! To all intents if you are diagnosed with a broken bone they have a 2 week window to operate as the bone is always growing and will simply fuse/join into whatever ways it's set. Did you break your wrist in January? Have you been prescribed any medication? Before I have Physio treatment I take prescribed meds and in addition 2 paracetamol as I know it's going to hurt. I must have had about 45 Physio sessions and was saying to the Physio Why is my wrist still so painful? It almost feels like I've now got a really bad sprained wrist and it's still sore and very stiff. However this is symptomatic of CRPS. Where have you been referred for your pm? I honestly thought that PM appointment would be the answer to my prayers but they said there is no cure for CRPS but they could perhaps help to bring the pain levels down so it's more manageable to cope with. However I am a fighter and I'm determined to give CRPS a good scrap. Can't cope with the thought that this condition is life long so we shall see. I feel that the more movement I'm getting that the burning/ sensitivity pain is reducing. Also at one stage my hand was covered in black hairs however this has now reduced to just the outside of my hand. But at the end of the day I just want my hand back. I want to make a fist with it but I'm only 30% there. So I think you will get your hand back but it's going to take a while. I know a friend of mine broke her wrist and it took her nearly 18 months to get her hand back to about 95% usage. Have you tried swimming? I done wrist December and tried swimming early April but wrist far too painful however 3 weeks ago tried again and now I'm fine with breast stroke. Also started tai chi 3 weeks ago and feel that this has been really beneficial. I hope this helps in some way, please keep in touch and good luck.

      Take care now x

       

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