Neuropathy after TKR: I'm 68 and fearful of future

Posted by daveage68 @daveage68, Jun 13, 2021

I had knee replacement 8 weeks ago. This seem to accelerate neuropathy in both lower legs. Numbness, feels like feet are freezing, legs feel heavy and tired after little exercise. I have always been very active, this is killing me.
Any success stories out there? I read where this is incurable Not sure if this is a quality of life I can live with. Do not want to be burden for wife and family. Looking for good news.

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@sueinmn

I think you are referring to your shin? It is very common for the nerves there to be damaged during TKR, and then have to heal and regenerate. The feeling is NOT pleasant. Nerves regenerate very slowly, but over time your brain accepts the feeling and it becomes less noticeable.

One thing does concern me though - you say " or sit at a desk for hours" - at this point in your recovery, whenever you are sitting for more than a few minutes, you ought to be elevating and icing your knee. @johnbishop can tell you about the advice he got from his doc after TKR.

Have you returned to work?
Sue

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It’s the muscle outside of my shin bone that is hurting like someone is stabbing it. The bone is fine. My surgeon suggested I might have a pinched nerve in my back causing pain. X-ray looked fine. Any chance it could be a blood clot on the side of my calf muscle though it isn’t warm or hard?

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@cnewberg

My surgeon released me at 5 weeks and said I could ride my bike, walk or anything. I had no pain. I didn’t start riding my bike until week 7. But the muscle pain on my shin is painful when I put weight on it. It has been like that since week 5-1/2. I had an X-ray and everything g looks great but when I stand it hurts like crazy. I was instructed that I only needed to ice if I’m swollen. My PT had me doing a full workout for 5 weeks 3x a week at the pt location that included leg lifts, bikes, stretching, and so on. I can bend my knee to 140 degrees. I am stretching my knee at home still. Walking my dog, but I wish surgeons would all tell us the same thing.

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Fortunately or unfortunately everyone heals differently and for your surgeon to plant ideas of how your recovery may turn out would be unfair to you. And if you didn’t heal in that prescribed manner you’d be on the phone with the doctor too. Having major surgery like you had takes a toll on many body systems and they all need to return to homeostasis after the surgical insult. Give yourself time after all most bone fractures are casted for at least a month and you essentially had two breaks. Have faith in your ability to heal yourself.

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@cnewberg

It’s the muscle outside of my shin bone that is hurting like someone is stabbing it. The bone is fine. My surgeon suggested I might have a pinched nerve in my back causing pain. X-ray looked fine. Any chance it could be a blood clot on the side of my calf muscle though it isn’t warm or hard?

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The symptoms you are describing don't sound likely to be a blood clot, but that could be checked in the doctor's office with ultrasound.
More likely, based on your activity description, your body is angry that you have not given it enough time to heal completely.
Ice is for more than swelling! My husband, an EMT in his early retirement, says if big Pharma could figure out how to patent it, ice would sell for $1 per cube. It does reduce swelling, but it also reduces inflammation, calms angry nerves and muscles, even can relieve pain.
My daughter had a traumatic fracture of her arm over a year ago, used ice multiple times a day for 5 months, then had another injury to it. Now, she still ices when it throbs or aches, and especially after she "challenges" it with activity.

May I suggest a visit to a PT experienced in dealing with longer-term pain? There may be other things you can try to help - gait correction (to correct changed body mechanics), specific stretches, infrared or ultrasound therapy, kinesio taping, even ice and elevation.

Do you plan to talk to the doc soon to get some help?
Sue

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@cnewberg

It’s the muscle outside of my shin bone that is hurting like someone is stabbing it. The bone is fine. My surgeon suggested I might have a pinched nerve in my back causing pain. X-ray looked fine. Any chance it could be a blood clot on the side of my calf muscle though it isn’t warm or hard?

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Get an MRI

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Good advice. I went and had an X-ray and my surgeon said everything was fine. I explained how everytime I step on the leg that had surgery I feel like I’m being stabbed in the left calf and it has gotten worse over the last three weeks. He said “I don’t think anything is wrong, I’d take 9 ibuprofen a day for three weeks and see if it heals” maybe also cut out exercise and ice as you may be icing too much since I told him I ice 4 hours over a 14 hour period. He said he wouldn’t do an MRI. Thinks I should just let it go and see if it’s better in 3 weeks. Is there nothing I can do?

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@cnewberg

Good advice. I went and had an X-ray and my surgeon said everything was fine. I explained how everytime I step on the leg that had surgery I feel like I’m being stabbed in the left calf and it has gotten worse over the last three weeks. He said “I don’t think anything is wrong, I’d take 9 ibuprofen a day for three weeks and see if it heals” maybe also cut out exercise and ice as you may be icing too much since I told him I ice 4 hours over a 14 hour period. He said he wouldn’t do an MRI. Thinks I should just let it go and see if it’s better in 3 weeks. Is there nothing I can do?

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If you take nine Ibuprofen a day for three weeks, you'll be lucky not to have a stomach ulcer.

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@txsongbird

If you take nine Ibuprofen a day for three weeks, you'll be lucky not to have a stomach ulcer.

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I was thinking about the same thing about that much ibuprofen, though I was thinking liver. I made a mistake of doing something similar that my GI doc recommended, and it messed up liver function after 4 weeks

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@cnewberg

Good advice. I went and had an X-ray and my surgeon said everything was fine. I explained how everytime I step on the leg that had surgery I feel like I’m being stabbed in the left calf and it has gotten worse over the last three weeks. He said “I don’t think anything is wrong, I’d take 9 ibuprofen a day for three weeks and see if it heals” maybe also cut out exercise and ice as you may be icing too much since I told him I ice 4 hours over a 14 hour period. He said he wouldn’t do an MRI. Thinks I should just let it go and see if it’s better in 3 weeks. Is there nothing I can do?

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First of all, unless you already have stomach or liver issues, 9 ibuprofen a day for 3 weeks is OK - just take it with food. Many people live for years on that dose or more without permanent issues.
Second, it sounds to me like you have an orthopedic surgeon who views his job as done if the implant is healing and not infected. Unfortunately there are some out there like that...
So, you can try his recommendation for a week and see what happens. If there is no improvement, it is time to decide whether to rely on the surgeon or find someone new.
Maybe it is time to find a physiatrist, a doctor who focuses on regaining and maintaining function, especially since you also have neuropathy?
Sue

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@dbeshears1

I was thinking about the same thing about that much ibuprofen, though I was thinking liver. I made a mistake of doing something similar that my GI doc recommended, and it messed up liver function after 4 weeks

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Yep, liver, too. I had a friend that used to work at the liver transplant center in NOLA. He said it was shocking how many people who were perfectly healthy came in after taking too much Ibuprofen (and some only ONE TIME) and had to immediately go on the liver transplant list.

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@dbeshears1

I was thinking about the same thing about that much ibuprofen, though I was thinking liver. I made a mistake of doing something similar that my GI doc recommended, and it messed up liver function after 4 weeks

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For years I took Motrin 800 (prescribed). I’m also on a lot of meds. My liver IS messed up. (I do have a inherited genetic defect that can cause it) I have to be careful what more I take. I have to take something for the neuropathy and the other conditions I have. That said, a person can’t reverse liver disease once it is damaged, but can stop its injury. I wish I knew back then what some otc items can do damage.

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