Can it be CPRS?

Hi all - I'm Dawn and this is my first post on here. I broke both my ankles back in August 16 - left one badly dislocated and bimalleolar fracture, plus "crumbled" metatarsals, right one non-displaced talus fractures on both sides of the ankle plus soft tissue damage. Left one was operated on, so multiple pins inside now, and in a cast for 9 weeks, then airboot right one was put in an airboot straightaway. Further background, I already had rheumatoid arthritis (though largely in remission), various hip and lower back issues and had been diagnosed with fibromyalgia at the beginning of last year. So I was already using crutches regularly at the time of my fall, and no stranger to pain and pain meds (I was am and taking co-codamol, gabapentin, etoricoxib and citalopram).

Six months on and although x-rays suggest the bones are healing well, my mobility is still very limited and pain, despite the cocktail of drugs is persistent and draining. To the above list add liquid morphine every night without which I cannot sleep. Of course much to be expected - the injuries were bad, both ankles meant a lengthy period of immobility, from which not only are my feet and leg muscles recovering but also back and hip. And I can't expect the pain I had before the injury to disappear either.

But I'm nevertheless worried that I'm not healing as well as I should. And my concerns are sharpened as I have to go back to work imminently or face a 50% cut (I know this will seem generous to many - but I'll find it difficult to manage). Since my physio muttered CRPS at a session a couple of months back I'm really concerned that I may have developed this condition. My left foot has been persistently a different colour from the right, more swollen (both swell still) and certainly in the early days clearly hotter. Before CRPS was mentioned I described one of the pains I was feeling as like electrical shocks, which progressed to stinging and burning, worse at night, hence the morphine. My physio says not to worry, as I don't have the hypersensitivity to pain and touch that many experience, and that in any case she is treating me as she would if I had this diagnosis (we are starting hydrotherapy next month), and I'm already on the drugs typically used. I mentioned to my GP - he didn't examine me but did increase my doseage of gabapentin.

Sorry for such a long post - won't happen again! But interested to hear from others - whether they have CRPS without all the symptoms, and whether I should push for a diagnosis now, or just wait to see how things develop.

3 Replies

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  • With the break crps is highly likely. However, you can remove the problem by doing exercises to stretch the effected muscles out. It is painful to stretch muscle out. The pain will go. It is very common for breaks to have muscles under going shortening from lack of use.

    Find a sports therapist who treats professional footballers. They should know what to do hopefully. They get injured footballers back playing again after many an injury.

    I would try to cut down on the pain killers. You need the sensitivity to get things working as they should. Pain killers will remove sensitivity and as a result make things much worse.

    Yoga is a good discipline to take up so as to learn more about your body.

    Hope this helps

  • Thanks for taking the time to reply John and for offering this helpful advice. I have certainly had positive experiences in the past with sports therapists when the NHS haven't offered help eg badly sprained ankle (I've a bit of history with ankles!). So definitely something I'll consider - for the moment my NHS physio has been v helpful, and I do do daily stretching exercises. She thinks being in the hydro pool will enable me to do more.

    Yoga came up today at a pain clinic group I'm attending - we are promised more advice next week on how it could work for the various conditions we all have. I've always thought it sounded attractive, but worried that I could manage it. But I'm desperate to be able to do a bit more exercise, so this may be the thing.

    As for the painkillers, you may well be right - and it's the fogginess and tiredness exacerbated by them that is making me most nervous about working again. But it's a vicious circle - although I still pretty much dread every step they take the edge off the pain enough so that I can endure my excersises and do some walking. I know some people might think taking morphine every night is too much, but it's the only thing that lets me have a pain free sleep (I have experimented without and just keep waking up with pain).

  • Thanks for the reply. Hope everything goes well.

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