Burning Skin Pain

Following a hypoxic brain injury in Oct 2004 I suffered from severe spacisity in my arms and legs. I was undergoing physical therapy to learn to walk again and this spacisity was greatly interferring. After trying all sorts of oral treatments it was determined that a IT Baclofen pump was the best treatment to deal with this problem. in Feb 2006 this was done. Immediately after the surgery I started having burning pain in my skin from the level of spinal insertion of the catheter down in my legs. I had suffered an allergic rash to Oxycodone immediately after surgery and thought this pain was a result of that. But after the rash was gone the pain still persisted. It feels like my skin is sunburned and only hurts when there is touch or friction. If I am sitting still there is no pain. I have undergone a shunt revision, spinal cord stimulator trial, and subcranial stimulator trial surgeries all in the last 12 months and none helped. I have seen my Neuurologist, Neurosurgen, OB/GYN, Internist Pain Management physician, and Psychiatrist all in an attempt to relieve this pain. I am on Cymbalta, Neurontin (gen. Gabapentin), Zanaflex, Synthroid, and Trazadone daily. I have also tried Lyraca for the pain and it did not work at all. The Neurontin helps a little ( bringing the pain from a 10 to a 9). I am seeing the Pain Management physician again tomorrow since my Neurosurgeon has said now that there is nothing more that he can do for me. I have had several lumbar xrays to ensure the catheter has not moved, and head MRI's...all are negative.

In doing my own research I have come across RSD and CRYPs. Could this be the problem due to the original ITB surgery? If not what can the cause of this pain be?? I am suffering so badly that in Dec 2006 I attempted suicide by overdose and I am almost at that point again. I am a single mom to a 3 year old and I need to be here to raise her. Can you possibly help me in any way>????

Please.....!!!!!!!!!!
Aimee

[JainMD]

Hi,
What is your name?
This could be a problem due to your ITB surgery.
I think it can be RSD.
Well to tell you about RSD, here the patients live with constant and severe burning and/or deep aching pain. Usually it is related to trauma or injury, but in lot of cases there is no apparent reason as it is in your case.
Many a times patients are not been understood properly by family members, health care workers and medical professional's. Often they are been told that there symptoms are in head.
In actuality, the sympathetic nervous system is in heightened alert state. Even the gentle stimulation of a light breeze on the skin creates tremendous pain.
Burning or aching pain in one or more extremities is the first sign of RSD.
The pain discourages movement, which leads to disuse muscle atrophy.
There are some who complaints of stiffness, hence making it difficult for them to initiate movement.
The stiffness can be alleviated with a sympathetic nerve block.
What is the treatment going on for you and what have the doctor's planned?
Is there any improvement?
Keep me informed.
Bye.

[aimster1970]

Hi Dr. Jain,
My name is Aimee. I am seeing the Pain Management Physician in the morning (or in a few hours...hehe). The only treatment that has done anything, but very little indeed, is the neurontim. I am on 1200 mg 3x a day. I have had a shunt revision, a spinal cord stimulator trial and a subcortical stimulator trial and all have failed. The doctor I am seeing in the morning is the one who did the scs trial and he already told me that he didn't think nerve blocks would help me. So I'm not sure he will offer any further treatments. I will post a note to you when I return home. Thank you for your quick response.
Aimee

[aimster1970]

PS I do not have any stiffness but the mere placing of someone's hand on my leg causes pain like their hand is a blow torch, even through my clothes.
Aimee

[JainMD]

Hi Aimee,
The treatment of RSD is difficult.
Approximately half of the patients can be managed non-operatively.
Desensitization measures include massage, electrical stimulation, and heat and ice treatments. Active range of motions should be encouraged, since disuse perpetuates the pain cycle; however, passive motion beyond the patient's tolerance may exacerbate the pain.
Keep me informed about your disease progression.
I would wait for your reply.
Bye.