High Tibial Osteotomy and CRPS

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Sorry in advance if this is long...

I was injured at work on 7/2016 which involved the tearing of my left medial meniscus. 2wks after my injury I had my 1st Arthoscopic surgey and proceeded to do PT for the next 6mths. During this time I explained to my Dr. that I was still having pain and visible swelling.

After having a 2nd MRI which showed another tear I had to have another Arthoscopic surgery.

Again, more PT followed for approx 2mths because of such intense pain and swelling I was forced to stop. Once again, I had another MRI which now showed that I had torn cartilage off my bone. I spoke with an OS and was advised that because I still had a little bit of good cartilage on the lateral side of my knee that I would not be a good canidate for a TKR.

I was told that my only other option was to have a HTO and that this procedure would buy me some time.

Shortly after having my HTO done I had some serious complications and need to have an emergency 4 compartment fasciaotomy done.

I kept having severe pain once out of the hospital that included swelling which was to be expected but I also have coldness in my calf area along with Severe burning sensation as well as the feeling of pins and needles being torn into my foot and lower leg as well as the severe pain.

I am now approx. 2.5mths post op from my HTO and my OS refered me to a pain management Dr who has since put me on Gabapentin and something similliar to lyrica (sorry I cant pronounce the name) and the PM DR has confirmed my CRPS. My question is this, What is eveyone doing to deal with the pain? I am currently back in PT I also am consistanly desanitizing my leg (forcefully rubbing my ands of my leg) even though the pain sooo bad. I am trying to constantly move my leg so it doesnt stiffen up though it is getting hard to do. Another issue I have is that the pain gets worse at night and I am sleeping approx 1-2hrs the whole night. My Dr's keep telling me that if the pain gets too bad I should go to the ER for pain control until I can get an appt to be seen. The problem is this, I am in sooo much pain that I would be making trips to the ER constantly whixh is something I DO NOT want to do.

please let me know anyones thoughts on this so I can cope a little better.

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  • Posted

    I am so sad and sorry to hear this. I pray you will get better. I too was diagnosed with Crps. Right now I soak my leg three times a day in Epsom salts. I also take lyrica. 

    Right now I am looking into calmare therapy and low dose nalrexone

    i pray one works. I will let you know

    keep desensitizing and researching. Never use ice. 

    you are in my prayers.

     

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  • Posted

    Hello.

    I have CRPS in my right foot and leg. I have had it for a little over 2 years.

    I take Gabapentin, Pristiq and Benadryl. The Benadryl has really helped my pain and swelling and it puts me to sleep and keeps me asleep.

    I take 600 mg of Gabapentin 3 times a day. One 50 mg Pristiq XR a day and 5O mg of Benadryl at bedtime.

    Do NOT use ice or compression or elevation to reduce swelling or to reduce the burning sensation. Ice will cause it to spread and damage the already damaged nerves. Compression and elevating the limb will only impede the delivery of oxygen and nutrients (blood) from the damaged tissues. Compression is hard in the nerves too. I made all of these mistakes before I knew I had CRPS and it made the CRPS worse.

    Also, conventional physical therapy DOES NOT work for CRPS. Only do physical therapy that is SPECIFICALLY for CRPS. If you cannot find a physical therapist who knows how to treat CRPS, look up exercises for CRPS on the internet. Look up aquatic exercises for CRPS.

    If there is a pool near you, try to do range of motion exercises in the deep end of the pool while using a pool noodle under your arms to keep you afloat.

    I did aquatic physical therapy in a warm salt water pool at the local hospital. It was going well until one therapist had me do conventional physical therapy exercises in the pool and it injured me further and the CRPS spread from just my foot and ankle up my leg. She had me do jumping jacks in the pool. I was in water up to my neck but the slamming against the bottom of the pool further injured me.

    I laid on the couch for a couple of months but I knew that I had to get moving again. I was on crutches the whole time.

    My local recreational center has a pool. So, I bought a pool noodle and got in the deep end and did all of the range of motion exercises I had learned in physical therapy. Sometimes I also walked in the pool in water about at my collar bone. I also did sidestep walking and crisscross walking in the same depth. Eventually I could swim laps with just moving my good leg. I was able to walk with the crutches, put my foot down but using the crutches still. I discovered that the pool chemicals were causing some pain in my foot but I was going every day and the pool was using WAY too many chemicals. So, keep that in mind and maybe go a few times a week and wash your foot well when you get out. I showered immediately after getting out of the pool. I used the center's handicapped changing room.

    During this time (the first CRPS year) I was taking the Pristiq and 2700 mg of Gabapentin a day. I was not taking the Benadryl at this time. I live in Colorado. I was taking a certain recently legalized substance. But only at bedtime. An edible. It helped so much with the pain, stopped the spasms, brought the swelling down and put me to sleep and kept me asleep.

    After a year I started to take 2 Benadryl at bedtime too. My pain became even less and I started walking without crutches in my kitchen. Then around the whole house, then outside then in public. At first I had a limp and I was slow but I was walking without the crutches and the pain became less and less. The limp went away and my pace quickened. I haven't had a spasm sine Christmas night 2016 and that was because I had some wine. My pain hasn't been above a 5 since the same Christmas night. I no longer take that legalized substance, I stopped May of this year and cut back the Gabapentin to 1800 mg a day. I still take the Pristiq and the 2 Benadryl at bedtime.

    I have been without crutches for a year and 2 months now. I never thought I would walk unaided again. I thought I would be in horrendous pain all the time. But I am walking by myself again, shopping, cleaning house, sleeping well and keeping the pain below a 4 or 5. Somedays it is a 1 or 2 or 3 or none, just some numbness. Other days it is a 4. Hardly ever a 5. The Benadryl at night brought the pain way down at night so I can sleep. Being able to walk has basically eliminated the swelling and discoloration.

    I avoid as much as I can- sugar, flour, pasta, spicy foods, caffeine, alcohol, potatoes, tomatoes, processed foods, franchise restaurant food, preservatives, artificial anything. I have found that all of these foods aggravate the pain, swelling and temperature of the CRPS. If I have any if these foods I know I will have elevated pain & swelling & the foot will get warmer & turn red.

    I went through the cold phase the first winter and spring (2015-2016) but doing the pool therapy and finally walking seems to have stopped the cold & cold burn phase. Sometimes it does get uncomfortably warm but usually only when I eat unhealthy. Then I hold it in front of a fan or run cool water over it.

    I don't put anything on the foot like lotion or ointment. I found that it aggravates the nerves.

    I use all natural soap and laundry products. Chemicals aggravate the nerves.

    Get fresh air and sunshine. I watched funny comedies and laughed. I read. I petted my cat, she wouldn't leave my side. Drink lots of clean water, eat clean. I worked crossword puzzles, worked jigsaw puzzles, colored in adult coloring books. I felt silly at first with the coloring but I found that I actually enjoyed it. It took my mind off the pain, it was creative and relaxing. Do something you enjoy. Of course being too physical right away is not a good idea but find things that are non physical that you enjoy. This is important. It takes your mind off the pain and gives you enjoyment.

    I found being mindful and grateful was helpful. Find something to be in awe of every day.

    Another exercise that is good for range of motion is tracing the alphabet in the air with your big toe. Point your foot and trace the alphabet capital letters then small cursive letters hold your knee still if you can. Just use your ankle. That will at least keep range of motion in your ankle.

    I had a piece of cake this evening and my foot is warm & red & stingy. I'm paying for that piece of cake. I made it from scratch with organic ingredients but it doesn't matter. It is still hurting. About a 3. Need to get it in front of the air conditioner.

    Ask me any questions. I am here to listen and help if I can.

    I hope you recover. I wish you less pain and more peace and blessings.

    Take care as best you can.

    I hope this helps.

    Gentle hugs, Tracy

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    • Posted

      Thank you for your response

      My Dr. gave me the ok to walk with 1 crutch, that lasted for about a week lol...I got rid of the crutch and am able to walk un assisted for the most part. Since having my HTO i now have a limp which, we all know PT for some reason thinks they can get rid of that. as far as my muscles go, I feel strong but with having crps it is extremely hard to keep pushing myself. I have been doing alot of pool PT but I also am doing the gym.

      I am still stuck on the point that this all happened because of a mensicual tear. After being told twice the 2 Dr's removed everything and then being told by the OS that I still have a tear plus cartilage tore off my bone and that I have bone on bone rubbing, this is ALOT for me to take in especially when I am the only working to provide for my family. I am a truck driver and have been driving for over 20yrs. Now I am being told that I will no longer be able to drive I feel stuck. Oh, and on top it all my pain is soo bad I consistantly cry my eyes out.

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    • Posted

      Hello.

      I am so sorry you are in so much pain and that you have CRPS. It is a difficult disease.

      CRPS can occur from even just a scratch in some people. They really don't know much about CRPS, what causes it or how to treat it.

      It is trial and error to find what works for you.

      Seriously, try Benadryl. Try it at bedtime. It'll knock you out and you can get some sleep. Sleep is SO important! Your body repairs itself while you sleep.

      There is another post on this forum where a lady says her son takes Benadryl for his CRPS. She says if he misses it he has pain. It has definitely helped my pain.

      My husband is a truck driver. He doesn't go over the road to often. He drives dump truck, flat bed and belly dump mostly locally in western Colorado.

      Since you were hurt at work can you sue for a monetary settlement? If you do be aware that workmen's comp will spy on you to see if you are faking the injury/disease. So, be careful what you do in your own yard or in public. They will screw you over in a heartbeat.

      Or will they retrain you to do something else?

      I am so sorry that you have so much to deal with. I'm praying for you.

      Take care. Gentle hugs.

      Tracy

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  • Posted

    Oh yeah, the desensitization. Start by touching the limb & foot with something soft. When you can stand that move on to something a little rougher and so on and so on. I started by when I was laying in bed I rubbed my foot on the sheets. Then a sock, a wet washcloth, the material of the couch as I laid there watching TV or coloring or working the Sunday crossword puzzle. Don't overstimulate the foot & limb too much. Start with soft items and for shorts periods of time during the day. Slow & easy & steady. Pace yourself.I can now use a soft bristled brush in the shower.

    When I showered I used to sit but the shower was actually the first place I started to stand unaided. Too hot of water hurts my foot still.

    Pace yourself with everything. Don't overdo, rest often but do keep the limb & joints moving just pace yourself.

    Take care,

    Tracy

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    • Posted

      Thank you so much! Your help , wisdom and care is so beautiful! I appreciate it so much!! 

      I keep you all in my prayers and heart as we win this together and support each other. 

      You are all In my prayers and sending gentle hugs from me too!smile 

      Colleen 

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    • Posted

      😊

      Meant to send this happy face. Like this one best! 

      Have a blessed day! 

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    • Posted

      Thank you for the response...I have been rubbing my leg often just to try to get the nerves built up I guess tou could say.

      I have also been doing alot of auquatic PT.

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