Jan Sibalt is married and the mother of 3 children. One day, while running after her 2-year-old child, she tripped and sprained her right ankle. At the time she did not think much of it, and she treated the pain from the twisted ankle with ice and elevation.
The pain persisted in the ankle, and after a couple of weeks, she noticed that the ankle itself continued to stay swollen and now had color changes. She found it painful if she put socks on that ankle or even if someone touched it inadvertently. In bed, she wound up tenting the end of her bed, so the sheets would not touch her ankle because of its extreme sensitivity.
After this went on for some time, she saw an orthopedic surgeon who referred her to our pain management clinic. She clearly had a disease called reflex sympathetic dystrophy or more technically complex regional pain syndrome.
When we described the disease process and the potential problems, Jan *Sibalt immediately began searching for answers on the Internet. She realized that RSD or CRPS could be a horribly debilitating disease and that the treatments for it involved medication management, nerve blocks, and spinal cord stimulation as well as physical therapy.
Initially, Jan was treated with certain types of antidepressants and nerve medications, which gave her some relief, yet she had persistent pain and was still unable to use that leg for any purposeful activity. She then underwent a sympathetic nerve block for the lower extremity, which gave her significant pain relief for weeks at a time, and after several go rounds with this, she realized that a permanent solution was needed. At that point spinal cord stimulation was discussed with Jan, and information was given to her, so she could explore this modality at length.
Being overwhelmed with the pain, she decided to go forward with a trial of spinal cord stimulation. During the trial when the stimulator was turned on, she started to scream, and all of us in the operating room were concerned that something was wrong, but the screams were screams of joy. She states she had never felt her pain stop in her foot for the 2 years that she had experienced this RSD pain. The trial continued for the next week, and she was able to increase her physical therapy, decrease her medication usage, and wear clothing while the trial was going on.
She eventually went to an implant with the spinal cord stimulator and is now 3 years out after the surgery. She continues to be active, caring for her 3 children, and takes essentially no oral medications.