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?

Interested in more discussions like this? Go to the Joint Replacements Support Group.

Still have it after 2 1/2 years and it is constant and worse at night. But my surgeon says it's not a result of his surgery. He did prescribe gabapentin from the get-go, as part of my go home medications, and the only medication I was to take on a three times a day schedule...but of course he still proclaimed that he saw not indication of nerve involvement with his work! I researched gabapentin and thought the side effects to be very risky and since my surgeon said there was no nerve involvement, I could not see why I should take it. He said...then don't!

REPLY
@ljn

Still have it after 2 1/2 years and it is constant and worse at night. But my surgeon says it's not a result of his surgery. He did prescribe gabapentin from the get-go, as part of my go home medications, and the only medication I was to take on a three times a day schedule...but of course he still proclaimed that he saw not indication of nerve involvement with his work! I researched gabapentin and thought the side effects to be very risky and since my surgeon said there was no nerve involvement, I could not see why I should take it. He said...then don't!

Jump to this post

Do an ABI test (pressure test for your legs) that is what I had done that found the knee surgeon pinched off the popliteal artery behind my knee and that the numbness was from no blood flow from my knee down. I am 2.5 years out and still have some tingling and numbness in my foot and it gets cold easily and hurts. But since I went almost 60 days before the artery was surgically opened I have some permanent damage to cells and tissue. When I told my knee surgeon what he did and asked why he keep saying it was normal he said and I'll never forget "Why did you wait so long to get it fixed you could of lost your leg" It was my primary that said it was not normal and ordered the ABI which showed little pressure in that leg.

REPLY

I posted about my experience and what caused my foot numbness tingling and pain. Pinched popliteal artery. have an ABI test done,

REPLY
@johnbishop

Hi @judylibb, I've had my right knee replaced and I also have neuropathy in my feet and just above my ankles but it was there before my knee replacement. My surgeon still went through all the risks and explained that neuropathy is one of them from complications. Sorry to hear you are having pain also with your neuropathy. I think there are several things that may help that you may want to discuss with your surgeon or doctor. There really is no cure for neuropathy unless you have a compressed or damaged nerve that can be fixed with surgery (my non medical opinion). As a fellow member with neuropathy I think our best option is to find something that provides relief from the symptoms.

You might find the following article helpful -- Mayo Clinic Q and A: Pain after knee replacement surgery: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-pain-after-knee-replacement-surgery/

You might also find the following discussion helpful as it covers pain from many conditions -- Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Have you discussed any alternatives to your current pain medication with your neurologist or doctor?

Jump to this post

Hi. I had a tkr on my right knee and three months later felt numbness in both my feet. So I don’t think it was anything the surgeon did. Seem to subside. Move on to 10 months later my left knee Done and 2 weeks later both feet went numb in the balls of my feet and toes. Seems it may be my gait with my flat overpronated feet after surgery. Decompression on the tarsaltunnel 3 times. Nothing changed. Very debilitating 3-4 yrs later.... 😪😪

REPLY
@kp6350

Hi. I had a tkr on my right knee and three months later felt numbness in both my feet. So I don’t think it was anything the surgeon did. Seem to subside. Move on to 10 months later my left knee Done and 2 weeks later both feet went numb in the balls of my feet and toes. Seems it may be my gait with my flat overpronated feet after surgery. Decompression on the tarsaltunnel 3 times. Nothing changed. Very debilitating 3-4 yrs later.... 😪😪

Jump to this post

@kp6350 I'm sorry to hear nothing has seemed to help your pain and numbness. You mentioned your gait may have something to do with it. Have you discussed your gait with your doctor to see if there may be physical therapy or other options to help with that?

REPLY

I am 72 and 4th day post 2nd TKR. The first one went fine a number of years ago. I am specifically addressing the neuropathy. I have had post-chemo neuropathy for over 10 years. There are a variety of drugs you can try.
i tried Gabapentin which knocked me out. I tried Lyrica which worked pretty well but made me feel drunk. The antidepressant Cymbalta is approved for neuralgia pain. I take Effexor XR which is another SNRI for depression. I took it years ago and stopped it once. My feet were so tender I could barely walk and went back on it. If neuropathy is impacting your balance, there are PT centers that specialize in balance therapy. I wear the hospital type socks at home constantly. They have a variety on Amazon. Make sure the backs of your heels are covered in any footwear. I have had a lot of falls and 2 TBIS due to my neuropathy. Started using a small crossbody purse for better balance and to keep my hands free. A pain clinic is a good place to go as they are usually persistent. Best of luck.

REPLY
@johnbishop

@kp6350 I'm sorry to hear nothing has seemed to help your pain and numbness. You mentioned your gait may have something to do with it. Have you discussed your gait with your doctor to see if there may be physical therapy or other options to help with that?

Jump to this post

I have had several sessions of PT to no avail. Also had a new pair of orthotics since this all started. The burning is unbearable at times. Don’t know what else to do. No one wants to hear it.,..

REPLY
@mues

I am 72 and 4th day post 2nd TKR. The first one went fine a number of years ago. I am specifically addressing the neuropathy. I have had post-chemo neuropathy for over 10 years. There are a variety of drugs you can try.
i tried Gabapentin which knocked me out. I tried Lyrica which worked pretty well but made me feel drunk. The antidepressant Cymbalta is approved for neuralgia pain. I take Effexor XR which is another SNRI for depression. I took it years ago and stopped it once. My feet were so tender I could barely walk and went back on it. If neuropathy is impacting your balance, there are PT centers that specialize in balance therapy. I wear the hospital type socks at home constantly. They have a variety on Amazon. Make sure the backs of your heels are covered in any footwear. I have had a lot of falls and 2 TBIS due to my neuropathy. Started using a small crossbody purse for better balance and to keep my hands free. A pain clinic is a good place to go as they are usually persistent. Best of luck.

Jump to this post

Hello @mues, Welcome to Connect. Thank you for sharing your experience and suggestions. I also wear hospital type socks at night to protect my feet when I have to get up in the middle of the night. Do you mind sharing how you found Connect?

REPLY
@kp6350

I have had several sessions of PT to no avail. Also had a new pair of orthotics since this all started. The burning is unbearable at times. Don’t know what else to do. No one wants to hear it.,..

Jump to this post

Have you tried Myofascial Release Therapy? There is a discussion you might want to read through to read the experiences of other members.

Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

REPLY

I am 8 weeks post-op TKR--right knee. My femur was fractured during surgery. I have been in a lot of pain, especially at night, where I alternate sleeping between the bed and a recliner and use either an ice machine or heating pad, depending on what might make it more comfortable to sleep for short periods of time. I was up 5 times during last night and finally just got up for the day at 7:00 a.m. I also noticed, as soon as the block wore off in the hospital, a feeling there was a strap on the brace that went under my arch, or someone had left a large piece of tape under my arch. The numbness/pins and needles are now affecting the outer ankle and up the outside of my leg. The surgeon said maybe the brace was too tight. PT said maybe a pinched nerve. I do still have scar tissue under the incision which I massage for several minutes a day and I seem to be eliminating some of it, as the scar is looking less "puckered". I got to remove the brace 2 weeks ago. I need to use a cane (sometimes my walker) because the foot neuropaathy makes me off balance. Getting up, I can barely stand on my leg and have to try and stand by leaning against the couch and gradually standing upright with my cane. I am feeling a little less knee pain now, but it makes the foot even more annoying. When I wear socks around the house, my foot swells and the sock feels too tight. I wear my loosest shoes, and my foot swells and the one shoe is too tight within a few minutes. I have to wear flipflops a lot of the time but the straps feel too tight after an hour or so. I don't know if this will ever resolve, but I am pretty unhappy because I feel a femoral fracture was a bad enough surprise to wake up to! Oh, and the surgeon told me at second post-op when I asked if I could have a nerve conduction study if my foot still had problems at my next post-op visit, "No, you won't need that. Your foot should be better on its own", and when I asked, "When?", he said it might be a few months to a year, or it "could last forever". What?!!

REPLY
Please sign in or register to post a reply.