KNEEtalk

The REHAB DEPARTMENT => Soft Tissue Healing Problems - General => Topic started by: Alyce on June 25, 2016, 12:46:03 AM

Title: Genicular Knee Block for RSD.
Post by: Alyce on June 25, 2016, 12:46:03 AM
It's been six years since I posted, but need some support/feedback.
I've had 5 failed knee surgeries in the last 14 years.  I will focus on the last three.
I had a rotational tibial osteotomy in 2009.  Everything that could go wrong did go wrong, including a paralytic ileus ( intestines shut down because on anesthesia and don't turn back on).  A PT rebroke the tibia 6 weeks after it had started to heal, then used a bone stimulator which worked in 2 months.  This time my surgical leg is purple/black, cold to the touch, changes in skin texture, constant pain.
The OS who did the surgery is in Detroit, and I'm in Atlanta.  We flew to see him 4 or 5 times post op.  He kept insisting that it was not RSD, and as soon as I started walking all symptoms would go away.  I was on crutches for 14 months, yep, I didn't walk for over a year.
All along my PT who I saw every week for 4 years, internist, chiropractor said It wasn't presenting like RSD.  So after 5 years I begged to see a neurologist.  He said I had RSD, and that a sympathetic nerve block would be both diagnostic and possibly help with pain. With the first one my foot was as hot as a lava rock.  I did get a little pain relief, but it didn't last.  In 6 months, I had 8 nerve blocks, and they stopped working.  I was so run down and after each week I would lay on the couch for 4 days.

They are recommending a genicular nerve block. I will have it as soon as feel better physically.  The neurologist told me that I would end up with that leg amputated and in a wheel chair.  I told him that I had lost a brother to ALS at age 29 and I didn't need a reality check.  I also said that those things would never happen to me. 
I do my PT every morning when I e-stim.  I walk a mile late in the day after supper is made, and any tasks are done.  I am in so much pain after the walk that I really can't stand at all.

I have sent several emails to the surgeon telling him that this was a death sentence for me.  He has grown children.  I asked him how would it be if they can't work or even volunteer.  He actually apologized.

I take amitriptyline, neurontin, klonopin, extra strength tylenol.  I refuse to take narcotics.  I would rather have a life with pain.

Anyway, if anyone has had the genicular knee block, I would appreciate your opinion.
The two things that have saved me have been daily meditating and Pilates.

Thanks for letting me blow off steam.
Title: Re: Genicular Knee Block for RSD.
Post by: MyKnee2010 on June 26, 2016, 06:10:15 PM
Wow, I am sorry you have had so many issues! I have had ongoing knee pain for the last 8 years. I've had both knees replaced (one replaced twice), numerous scopes, as well as several nerve surgeries/procedures. Nothing has really helped & now I'm probably looking at replacing both knees again.

Anyways, I saw you were asking about genicular knee block. I had this procedure done to my right knee back in May. First they did a nerve block to the three main genicular nerves. My nerves are very sensitive so I wasn't surprised that it just made my knee hurt more. I especially had pain at the top medial point where I had never had had pain before. It kind of seemed like the pain at the other two points was less so we decided to go ahead a few weeks later with the genicular knee ablation where they burn the nerves using radio frequency to generate heat (don't really know how it all works).

When they did the ablation, I was really sore. They do so much poking & jabbing of needles & probes that I wasn't surprised I hurt so much. The biggest problem I had was that the pain at the top medial point was intense! I guess the other 2 points felt better but I was hurting so bad from the top medial point that any other pain would probably not even registered with me. The pain lasted about 7 weeks, that I guess is when the ablation wore off because I went back to the pain I had before the block & ablation.

I guess the only good thing to come from this is that I am glad I am back to the familiar pain instead of the pain I felt after the block & ablation. This pain is still too much for me to function normally so I am going to talk to my OS again in another month to discuss replacing this knee again.

I should add that my knees are very different than most I guess. Every OS & other doctor I have ever been to have said they have never seen knees react the way mine do. These are doctors who have been practicing for at least 20 years or more. So, just because this was a bad idea for my knee doesn't mean it wouldn't help yours. This is just my experience, take it for what it's worth.

Whatever you end up doing, I hope you soon get some relief from the pain!