Foot neuropathy (numbness and pain) after total knee replacement (TKR)

Posted by norby @norby, Nov 26, 2018

I had a right total knee replacement 10 weeks ago and came out of surgery with numbness and intermittent pain on the bottom of my right foot. However, I do have good motor function in that foot. The knee has been healing and with PT, movement is on track, but the foot is a major challenge. The foot pain at times is worse than any from the knee. I have been able to generally manage the foot pain with gabapentin. My surgeon believes this may resolve in time but may take from 6-12 months. However there is a possibility that it will never go away. Has anyone else experienced foot neuropathy following knee replacement? If so, what was your experience with it?

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Hi, I happened to see your post. I had TKR for my left knee in 2012. I still have pain in the bottom of my foot, tingling, and sensitivity to cold. More pain if I don’t keep my foot warm with wool socks, slippers always in my house, sometimes little charcoal activated foot warmers and good boots, in winter, the boots. I put Aspercream with lidocaine on the bottom of my foot and a wool sock at night, summer and winter. It doesn’t bother as much during the day when I’m busy etc, but nighttime is unpleasant. I hope you have had better luck. Mine isn’t going away. But you do learn to live with it and make the best.

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@marynajdek

Hi, I happened to see your post. I had TKR for my left knee in 2012. I still have pain in the bottom of my foot, tingling, and sensitivity to cold. More pain if I don’t keep my foot warm with wool socks, slippers always in my house, sometimes little charcoal activated foot warmers and good boots, in winter, the boots. I put Aspercream with lidocaine on the bottom of my foot and a wool sock at night, summer and winter. It doesn’t bother as much during the day when I’m busy etc, but nighttime is unpleasant. I hope you have had better luck. Mine isn’t going away. But you do learn to live with it and make the best.

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Hello @marynajdek, Welcome to Connect and thank you for sharing your experience and what has helped you. I think having a positive attitude and taking it day by day really helps. Do you have the pain and sensitivity in both feet or just the one in the leg that had the knee replacement?

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@johnbishop

Hello @marynajdek, Welcome to Connect and thank you for sharing your experience and what has helped you. I think having a positive attitude and taking it day by day really helps. Do you have the pain and sensitivity in both feet or just the one in the leg that had the knee replacement?

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Only the foot on the side of my TKR. Actually I have numbness that is not nearly as strong up past my knee. At times this “nerve pain” is bad enough that I have to get up and “walk it out”, so to speak. Hard to discribe also I feel the night following surgery onto my surgical side, causing bruising from the top of my leg to the foot. My surgeon was very unhelpful. Didn’t even want to do X-rays. But the nurses insisted. Never really heard anything about them. My experience was unusual and not typical but I will never have my other knee done. Both knees hurt. So it didn’t work out for me. And doctors are not all the same.

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@marynajdek

Only the foot on the side of my TKR. Actually I have numbness that is not nearly as strong up past my knee. At times this “nerve pain” is bad enough that I have to get up and “walk it out”, so to speak. Hard to discribe also I feel the night following surgery onto my surgical side, causing bruising from the top of my leg to the foot. My surgeon was very unhelpful. Didn’t even want to do X-rays. But the nurses insisted. Never really heard anything about them. My experience was unusual and not typical but I will never have my other knee done. Both knees hurt. So it didn’t work out for me. And doctors are not all the same.

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@marynajdek, Can you ask them to share the results of the X-rays taken after the fall with you? Maybe you could get a second opinion on the X-rays to see if there was some possible damage or nerve compression after the fall.

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@gator1965

I am nearly 8 months following my total knee replacement. I have a neuropathic type of pain which has been present since the replacement. I have a numbness and tingling type sensation which is constant, and i cannot bear anyone or anything touching this part, it sends out a shooting type of pain. Initially I could not even have a sheet over it. I also have a burning type of pain down my leg. My physio recommended that I try different textures rubbing the knee to desensitise the area from towel, tissue to toothbrush! I haven't tried the toothbrush yet!!
I do still experience swelling to the leg
My surgeon prescribed baclofen and amitriptyline at night. My GP is still juggling the dosages around, and I am still taking regular paracetamol and brufen.

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I had complete foot drop after my total knee replacement with no mobility and movement below the knee. I now have full mobility which took 6 months. I still have very painful neuropathy on the top of my foot which makes a shoe almost impossible even with Gabapentin 4 times a day. I saw a neurologist in 2018 a couple months post op. She said my peripheral nerve that runs up behind my knee was pinched in the replacement. After 3 years I’m heading back to a neurologist for help. I want to know if they can release that pressure surgically or if I need to lose weight to take off pressure to stop it. I’m sure they will suggest weight loss first. So sorry you struggled as well. Up here in the Northland shoes are a must.

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I just read through the posts on this topic. I identify with leg and feet problems. My knee replacements and follow-up physical therapies went well. I have no beef with any of the medical people. There are risks I did not know about at the time. About a year after the right tkr I was hospitalized with a huge blood clot in that same leg. For about two years afterwards I had blood clot scares and was placed on blood thinners for a long time. Shortly after the large blood clot I read that blood clots are one of the possible side effects of knee replacement surgery. I am gonna be straight up, my knee hurt. It hurt badly. I would have chosen surgery even if someone had warned me about possible clotgs. I have no idea if multiple leg and feet problems tie back to the surgery. I am going 69, overweight, a recovering alcoholic and addict, have insomnia and, mostly because of foot and leg problems, am sedentary. So I would be hard pressed to know if the knee surgeries created the environment for the
problems I experience (other than the blood clot). The frustration, pain, emotional distress and more are a high price to pay.

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@butter12

I had complete foot drop after my total knee replacement with no mobility and movement below the knee. I now have full mobility which took 6 months. I still have very painful neuropathy on the top of my foot which makes a shoe almost impossible even with Gabapentin 4 times a day. I saw a neurologist in 2018 a couple months post op. She said my peripheral nerve that runs up behind my knee was pinched in the replacement. After 3 years I’m heading back to a neurologist for help. I want to know if they can release that pressure surgically or if I need to lose weight to take off pressure to stop it. I’m sure they will suggest weight loss first. So sorry you struggled as well. Up here in the Northland shoes are a must.

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My experience with TKR is similar to butter12’s. After surgery in June’19, I had a DVT and a 14cm hematoma which resulted in foot drop as well. I had lots of swelling and pain from the knee down, not to mention a rainbow of colors. It is now February 2021 and I have regained most of my movement, but the neuropathy and swelling still persist along with the inability to feel most of my (L) foot. I have sensations like my foot is in cold water and if I stub it, the sensation is like a shock. The feelings like my toes (especially my big toe) are exploding have largely subsided thankfully. I have cancelled appointments with neurologists and physiatrists largely due to COVID fears, but intend to reschedule asap. I take 600 mg gabapentin 3x daily and I really pay a price if I miss a dose. My coverage for PT ran out last February but I still continue on my own about 3x weekly. My experience was horrendous, I spent 4 months in a hospital and/or nursing homes, but I consider myself lucky in that I can still walk and drive my manual shift Mustang. The desire to drive again was a great motivator for me. I also had a therapist who went through foot drop and he helped. I am a strong believer in the power of prayer and faith. I believe there really is a connection between the spirit and the body. I am approaching my 1 year anniversary of being off antibiotics, and am thankful to be infection free every day I wake up. God has so far proved my pragmatic ID doc wrong about my chances of getting an infection. I am not proselytizing here but simply giving praise where I think it is due. Miracles happen every day if we only choose to recognize them as such.

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@marynajdek

Only the foot on the side of my TKR. Actually I have numbness that is not nearly as strong up past my knee. At times this “nerve pain” is bad enough that I have to get up and “walk it out”, so to speak. Hard to discribe also I feel the night following surgery onto my surgical side, causing bruising from the top of my leg to the foot. My surgeon was very unhelpful. Didn’t even want to do X-rays. But the nurses insisted. Never really heard anything about them. My experience was unusual and not typical but I will never have my other knee done. Both knees hurt. So it didn’t work out for me. And doctors are not all the same.

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marynajdek @marynajdek
thanks for posting your experience. I was really curious if they ever figured out the nerve pain/numbness. When I woke up from surgery I had no feeling in my leg and foot felt like it was severely asleep. It buckled when I stood on it. Was told so many times that "it's normal" that I was about to give up. Then my primary said that is not normal, your foot/leg should not be numb,tingly, and cold, and toes should not be purple. She sent me for an ABI which showed low pressure in that lower leg. I was sent to a cardiologist and then had angiogram. Yup popliteal artery right behind the knee totally pinched shut...no blood flow to my lower leg/foot for the past 6 weeks!. I was sent to a surgeon who did surgery and took out the clot...no more purple toes and foot was warm! It was 50% better right away but still some numbness and tingling. It's hard to describe how it feels. That surgeon said with lack of blood to that area there will probably have cell and tissue damage and will never be "normal" again. I,like you, leave in a cold region, Minnesota, and have to wear socks and shoes ALL the time summer or winter. If not the foot gets cold feeling and hurts. Looked into a lawyer, (only because at my 1 year said "I suppose there will be law suit) but found out my "wonderful" TKR surgeon lied on ALL my office visits and surgery report with him and put nothing down about a cold, numb, tingly, purple foot. I have a 2 year appointment coming up and don't know if I should see him again or not. I would like to report him to the medical board.
Best of luck with your foot and wish you all the best! We are not alone!

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hello, just checking in to see if you ever got any results on your foot. Is it the same, better! I'm 2 years out and no better.

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@butter12

I had complete foot drop after my total knee replacement with no mobility and movement below the knee. I now have full mobility which took 6 months. I still have very painful neuropathy on the top of my foot which makes a shoe almost impossible even with Gabapentin 4 times a day. I saw a neurologist in 2018 a couple months post op. She said my peripheral nerve that runs up behind my knee was pinched in the replacement. After 3 years I’m heading back to a neurologist for help. I want to know if they can release that pressure surgically or if I need to lose weight to take off pressure to stop it. I’m sure they will suggest weight loss first. So sorry you struggled as well. Up here in the Northland shoes are a must.

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@marynajdek I'd like to extend my welcome to Mayo Clinic Connect. @butter12 Welcome to Mayo Clinic Connect and @bluebrass I'd like to welcome you back to Mayo Clinic Connect.

All of you had complications related to total knee replacement and have that experience to share.

@butter12 You have regained full mobility 6 months after surgery but you still experience neuropathy. You are considering surgery for a pinched peripheral nerve and you are wondering if they will first suggest weight loss?

@bluebrass It sounds like your experience was similar.

Members like @sunnybuns1 @anncgrl @loriaakre @glokart1957 @navyqas @suewilliamaon @janedahlgren @josie1957 have discussed this topic and may be able to offer support.

@butter12 May I ask how physical therapy went and what your physical therapist had to say about the neuropathy?

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