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Ask your medical question here. : MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.
RSD or intraoperative back injury?
Three years ago I had the great toe joint in one foot replaced with a titanium implant and a Morton's neuroma removed at the same time from that foot. There was an unusual amount of post-op swelling even with keeping the foot elevated at all times, and it continued to have odd vascular changes for years, turning purplish-black with a few seconds of standing for the first two years. At the same time, the foot had a distinct sensation of being burned and crushed simultaneously. That has diminished only slightly. I also had severely painful muscle spasms from my lower back, with most of the muscles in the pelvic floor and the whole leg remaining in spasm. After PT was ineffective, I was referred to a pain management MD who diagnosed RSD. Now, the limb is noticeably smaller than the other and continues mild constant spasms and pain that tracks the path of the sciatic nerve, originating in my lower back.
I have Ehler's-Danlos and it occurred to me the other day that I have never had surgery but that being moved off the table while sedated caused an injury that took quite some time to heal. The astounding and unremitting pain after the foot surgery started the day of the surgery, not later as you might expect from RSD. Is it possible that being dragged off the OR chair harmed nerves in my lower back, and that I might have something that could be helped? Would an MRI show damage that was unseen on previous CT?
Gender: Female
How tall are you (feet and inches)?: 5'11
What is your weight in pounds?: 160
How old are you?: 52
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Abdominal Pain
Musculoskeletal Pain
Neurological
Describe associated symptoms not listed above: Increased pain down legs from back immediately before and after bowel movements.
Swelling in foot, redness and warmth at joint replacement site
What have you done so far to remedy this condition? Please include tests and relevant studies here.
: CT: lumbar facet disease, SI joint abnormalities
MS ruled out by MRI brain
Lyrica prescribed, helped for two weeks, caused large weight gain, stopped taking.
NSAIDs, stopped with onset of collagenous colitis
Neurontin and Xanaflex at bedtime
Magnesium malate and calcium supplements
Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Hashimoto's, now well controlled with Synthroid
Ehler's-Danlos with vascular and skeletal effects, especially bruising, low blood pressure, easily dislocated shoulders, knees, and hip joints, eye deformities.
Collagenous colitis.
Surgery: Lasik eye surgery, adenoids and tonsils as adult, benign breast tumors, benign tumors of the Fallopian tubes, Obdurator space hernia and femoral space hernia repairs, lap chole, vag hyst, rectocele and cystocele repairs, bone spur removal hallux joints.
Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cardiac Disease
History of Back Pain
Please list any medication allergies that you have : : sulfa: hives, throat swelling
Please list any medications you are currently taking (and dosage if known) :: Neurontin 600 mg hs
Xanaflex 4mg hs
When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Daily
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days
Tell us your top three things you wish to be addressed in our response.: Should I ask for an MRI of my back and/or foot?
Should I see a neurosurgeon or an ortho guy about the pain that starts in my back, rackets around in my guts, and shoots down my leg?
Is it possible that an intra-op back injury could mimic RSD?
Ask your medical question here. : MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.
RSD or intraoperative back injury?
Three years ago I had the great toe joint in one foot replaced with a titanium implant and a Morton's neuroma removed at the same time from that foot. There was an unusual amount of post-op swelling even with keeping the foot elevated at all times, and it continued to have odd vascular changes for years, turning purplish-black with a few seconds of standing for the first two years. At the same time, the foot had a distinct sensation of being burned and crushed simultaneously. That has diminished only slightly. I also had severely painful muscle spasms from my lower back, with most of the muscles in the pelvic floor and the whole leg remaining in spasm. After PT was ineffective, I was referred to a pain management MD who diagnosed RSD. Now, the limb is noticeably smaller than the other and continues mild constant spasms and pain that tracks the path of the sciatic nerve, originating in my lower back.
I have Ehler's-Danlos and it occurred to me the other day that I have never had surgery but that being moved off the table while sedated caused an injury that took quite some time to heal. The astounding and unremitting pain after the foot surgery started the day of the surgery, not later as you might expect from RSD. Is it possible that being dragged off the OR chair harmed nerves in my lower back, and that I might have something that could be helped? Would an MRI show damage that was unseen on previous CT?
Gender: Female
How tall are you (feet and inches)?: 5'11
What is your weight in pounds?: 160
How old are you?: 52
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Abdominal Pain
Musculoskeletal Pain
Neurological
Describe associated symptoms not listed above: Increased pain down legs from back immediately before and after bowel movements.
Swelling in foot, redness and warmth at joint replacement site
What have you done so far to remedy this condition? Please include tests and relevant studies here.
: CT: lumbar facet disease, SI joint abnormalities
MS ruled out by MRI brain
Lyrica prescribed, helped for two weeks, caused large weight gain, stopped taking.
NSAIDs, stopped with onset of collagenous colitis
Neurontin and Xanaflex at bedtime
Magnesium malate and calcium supplements
Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Hashimoto's, now well controlled with Synthroid
Ehler's-Danlos with vascular and skeletal effects, especially bruising, low blood pressure, easily dislocated shoulders, knees, and hip joints, eye deformities.
Collagenous colitis.
Surgery: Lasik eye surgery, adenoids and tonsils as adult, benign breast tumors, benign tumors of the Fallopian tubes, Obdurator space hernia and femoral space hernia repairs, lap chole, vag hyst, rectocele and cystocele repairs, bone spur removal hallux joints.
Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cardiac Disease
History of Back Pain
Please list any medication allergies that you have : : sulfa: hives, throat swelling
Please list any medications you are currently taking (and dosage if known) :: Neurontin 600 mg hs
Xanaflex 4mg hs
When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Daily
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days
Tell us your top three things you wish to be addressed in our response.: Should I ask for an MRI of my back and/or foot?
Should I see a neurosurgeon or an ortho guy about the pain that starts in my back, rackets around in my guts, and shoots down my leg?
Is it possible that an intra-op back injury could mimic RSD?
2 comments:
Dear RSD,
I will be the first to tell you that this is WAY out of my area of expertise! However, with the symptoms that you mention, especially the more objective one of atrophy of the affected leg, I think an MRI of the lumbar spine is most definitely in order! I'd also consider vascular studies to ensure that there is an adequate arterial supply to that leg.
Since this is not an acute problem, and because MRIs are not typically done from the ED, I don't think you need to rush off tonight to get this done. However, I would say that a phone call to your primary doctor TOMORROW is in order! I am a little surprised that an MRI wasn't ordered after PT failed - but definitely make sure that your PCP knows of the duration and progression of the symptoms.
Good luck - and let us know what you learn!
Doc 7
Thanks! My ABI is perfect, no arterial problems; just the problem of the veins not returning the blood well. I've developed a huge new network of veins since the injury and the purple discoloration is rare now. I made an appointment today and will ask for an MRI. Just in time, too, the pain made my foot feel numb today and I took a bad fall off the back steps!
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