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complex regional pinsyndrome
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complex regional pinsyndrome

after a torn meniscus surgery in august severe pain and swelling still. took another mri showed another tear but new surgeon states trauma from torn meniscus surgery in august would only make another surgery worse.  suggested pain management.  pain management injected left side of left knee with kenalog and marcaine, pain was relieved tremendously.  today just injected right side of the left knee though told me he didnt think the side mattered as the steroid spreads as long as it is injected into the patella. since my body is weird i insisted he inject the right side the most painful anyway.  Now the pain is still there but subsided tremendously.  He was not sure I had crps though bone scan suggested it, He was talking about possible synvisc injections in 6 weeks, last resort is an epidural.  You see I suffer from narcolepsy/cataplexy and pain triggers off muscle tone loss of total body so even upon inserting the injection I would go limp hear everything but cant move., part of the cataplexy.  So an epidural would require intubation as Ive had 5 brain stem ones when I bled in brain in 2003 from an fda experimental drug called ghb to help the narcolepsy, after that was left for 3 years with severe neuropathic pain, nothing helped but morphene, fenatanal, zanaflex and baclofen which i presently take, since this md feels its to dangerous he wants to try the other approach.  My question is should i get the synvisc or do another kenalog/marcaine injection and since other leg with a unicompartmental in 2008 now loosened and needs to be done over so i changed to special surgery. this injection should i baby it with the ice and rest..  i know my case is weird.  i live in nyc . and presently go to hospital for special surgery as a second opinion as original surgeon didnt know wht it was and just wanted to give epidural in office, and i thought he was crazy.
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if your pain is responding to local steroid injections, it is probably not CRPS. I have at least one patient with narcolepsy, and she kept reinjuring her knee after falling out.  It sounds like there may indeed be a new tear, and that a second arthroscopy is necessary.
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I'm not a doctor but have been presented with sympathetic nerve blocks as a way of diagnosing and possibly treating pain "left over" from a cuboid fracture in my mid-foot.  CRPS and RSD are the ADHD of the year.  Read the medical journals about the injection.  Know exactly what you're getting into before you let anyone do a nerve block at the spinal level.  See a physical medicine specialist or pain clinic.  Your insurance carrier should have one in network.  And a pain clinic isn't just for treatment, they diagnose as well.  Physical medicine have methods for diagnosing sources of pain without nerve blocks. Kaiser has both departments under one roof.  The podiatrist and orthopedic surgeon wanted to inject me as a cop out.  Easier to say its RSD than look for the problem.  It could be bursitis, or many other things.  Get an MRI.  My radiologist looked at my MRI and bone scan and said no RSD or CRPS!!!  Going the chronic pain route is serious and using just nerve blocks is a VERY serious way to do exploratory diagnosis of the source of pain.  Even my physical medicine specialist said the possibility of nerve damage was too great to warrant such a procedure.  Push the doctors to look further before letting ANYONE stick a needle into your back.  Just my two cents but from experience.  
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