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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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heyjoe415 | @heyjoe415 | Nov 4, 2022
In reply to @cat082011 "Hi, Two weeks ago, I started having burning pain in my thigh. I also have tingling..." + (show)
@cat082011

Hi,

Two weeks ago, I started having burning pain in my thigh. I also have tingling and pain on the side off my calf and into my foot. I went to my doctor yesterday for my three month checkup after hip replacement surgery and I was told it was neuropathy, the nerves coming back to life. Woo hoo, i get to be one of the small percentage of patients who get this. The doctor said that it could take 6-9 month to go away. I was wondering what you did for your foot neuropathy for all those months. Did you do physical therapy or take any medication?

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Hi cat,

I'm sorry for what you're going through. Quick question. Has sciatica been ruled out? Your symptoms sound similar to mine when I had sciatica - pain and numbness in my hamstring muscles and calf muscle. I did not have pain or numbness in my foot, but that can be caused by sciatica.

Anyway, just something you might want to ask about. Be well!

Joe

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sdhkkjmz | @sdhkkjmz | Nov 5, 2022

Pins and needle pain started in my foot from the moment I work from my second total knee. It’s taken 3 EMG’s and 2 years to finally receive a diagnosis of peripheral neuropathy. I have sent 2 requests to Mayo to be seen by their neurology dept after the first was denied. I’ve had test after test and nobody seems able to help so far. I’m afraid after 2 years that it is permanent. Then I had the first knee replacement in 2018 I had the pain but not numbness and pins and needles. That was diagnosed as sciatic and I had numerous ryzodimies and epidural steroid injections to deal with that but didn’t realize what was to come as far as the neuropathy. The sciatica and the neuropathy are very different and while both painful and difficult to handle the neuropathy wins out as far as the daily pain and how it gets more intense at night. I’m up all night and wishing my feet were gone. I currently as still having ryzodimies every 6 months and epidural steroid injections in my back to try to combat the pain but it’s not working. If anyone has any thought on what to try after the PT, acupuncture, massage, bio freeze and various other home remedies. Nothing is working even gabapentin. HELP!

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sambles12 | @sambles12 | Nov 7, 2022
In reply to @rjstroebel "Yes, I also am experiencing same foot neuropathy. Post 22 weeks TKR. Burning\cold throbbing pain on..." + (show)
@rjstroebel

Yes,
I also am experiencing same foot neuropathy.
Post 22 weeks TKR.
Burning\cold throbbing pain on top of foot at webspace of 2nd\3rd toes.
I beleive its due to the tornequet the Anestesialogist strapped on me just before putting me out for the procedure.
He said "Its so we can give you a nerve block in the upper thigh" But the surgeon later (1st post visit) said its also so "You dont bleed into the joint during the first part of procedure" and that it was only on for 15 minutes.
Days later at home, and after the nerve block wore off, I experienced some really sore upper thigh pain with yellowing\black and blue soreness on side of and behind the thigh. DR said it was from the tornequet.
So, I beleive the Deep Peroneal nerve (from the hip to the webspace of 1\2nd toes was compressed by the tornequet strap and I'm now living with a new pain I never had before this TKR.
The Dr has had me on and still on (Gaberpentin and Celebrex). I see him in 3 weeks for 6 month post visit and will INSIST he send me to a neurologist for he foot burning pain.

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I’m 6wks post tkr - I’m having the same issues . The minute I woke in recovery the pain from the hip and thigh was unbearable. It’s not much better now. I’m not sleeping . And my incision is still not fully healed or closed. I’ve had several major gynae ops in the past and I know I heal amazingly. I’m fit and healthy & 51, There is absolutely no reason why I wouldn’t be healing at my normal rate. My concern is it’s related to this neurological pain. I’m suffering with sciatic pain from my back, hip inside groin and outer (IT band) again been on tramadol, gabapentin, sleeping is so uncomfortable. I’m
Lucky if I get 3 hrs a night . It doesn’t feel like it’s getting any better at all. My knee itself is so stiff it feels tight and constricted, again it’s just not getting any easier. Please help please grateful for advice from similar . TIA

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2 replies
fixdirt | @fixdirt | Nov 20, 2022
In reply to @josiem "I had a total knee replacement 8 months ago on my left knee and I have..." + (show)
@josiem

I had a total knee replacement 8 months ago on my left knee and I have had numbness on my foot ever since. I know that numbness on the side of the knee is normal after knee replacement but not the foot. I mentioned it to my doctor and he said it could get better in time, well here it is 8 months later and there is no chance. He sent me to have a nerve test done which revealed that I the nerve impulses were slow on my leg. The doctor than sent me to a pain management doctor who did an MRI which revealed that I have a bulged disk. However, prior to the surgery I was not having any problems regardless weather the bulge disk is there or not. She then had me go into the hospital and injected with a steroid shot on my spin and said if it was a pich nerve from the bulged disk, that should help relieve the pressure and the feeling on my foot should return. Well, two, weeks passes, and nothing. I went back for my follow up and she than informed me that the injection should have worked. She than tells me that now she believes what she thought all along, but wanted to make sure, that the nerve on my knee had been damaged during surger. She said that it might get better on its own but chances are that it might not. Now, I have pain all the time. And can’t go with out wearing shoes. I get cramps and the out side of my leg also hurts.
The numbness feels like a pressured a pressure cuff. Everyday I wait for it to wake up.
Does anyone know if there is any kind of surgery that can repair damaged nerves?

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I had a total left knee replacement on October 10 and immediately after the surgery had a constant shocking nerve pain in the top of my left foot. It’s been over six weeks from the surgery and the nerve pain has not stopped. I told my surgeon about the terrible pain and he said it’s probably coming from your back. I told him I never had this nerve pain until the surgery and he pretty much said it’s not from my surgery.
Fixdirt

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1 reply
willw | @willw | Nov 20, 2022

Hello (I'm not entirely confident in using this medium) I had TKR left knee on 9/16/22...Currently I'm still using a walker. My PT really wants to get me up and walking, however my foot seems to be the problem. I suspect that the surgeon really torqued my bowed leg and made it straight. I'm happy to have a straight leg. The knee seems okay. My foot on the other hand is swollen all around. The more I try a cane, the sorer it becomes. I'm not sure how to progress. I saw a podiatrist and he was flummoxed. He said take it easy. I'm determined to not let the foot stop me from walking...I'm not sure how to proceed. Yesterday I walked with a cane, it was wonderful, but I pay for it with a sore swollen foot. Thoughts?

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quasidomo204 | @quasidomo204 | Nov 21, 2022
In reply to @fixdirt "I had a total left knee replacement on October 10 and immediately after the surgery had..." + (show)
@fixdirt

I had a total left knee replacement on October 10 and immediately after the surgery had a constant shocking nerve pain in the top of my left foot. It’s been over six weeks from the surgery and the nerve pain has not stopped. I told my surgeon about the terrible pain and he said it’s probably coming from your back. I told him I never had this nerve pain until the surgery and he pretty much said it’s not from my surgery.
Fixdirt

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There are nerves that run by the knee area that can get inflamed. Would suggest an MRI to identify any soft tissue, nerve or other contributing factors. Neurologist may help with MRI results with encouraging nerve meds like gabapentin to reduce the shooting pain.

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phigg | @phigg | Nov 22, 2022

I have numbness and shooting pains in my foot and my knee 9 months after TRKR. I was very active before my knee replacement and still am. The foot has improved somewhat and I have weened myself off gabapentin. I see my surgeon next month and will ask for a referral to a neurologist. I don’t think it was the nerve block that caused this and want to get an MRI. I can live with this condition, getting used to it, although it I have my moments moments especially after a long day. The bigger problem is that I need a total right shoulder replacement and am putting it off because I am afraid to have another surgery.

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cindymattern | @cindymattern | Nov 23, 2022
In reply to @sambles12 "I’m 6wks post tkr - I’m having the same issues . The minute I woke in..." + (show)
@sambles12

I’m 6wks post tkr - I’m having the same issues . The minute I woke in recovery the pain from the hip and thigh was unbearable. It’s not much better now. I’m not sleeping . And my incision is still not fully healed or closed. I’ve had several major gynae ops in the past and I know I heal amazingly. I’m fit and healthy & 51, There is absolutely no reason why I wouldn’t be healing at my normal rate. My concern is it’s related to this neurological pain. I’m suffering with sciatic pain from my back, hip inside groin and outer (IT band) again been on tramadol, gabapentin, sleeping is so uncomfortable. I’m
Lucky if I get 3 hrs a night . It doesn’t feel like it’s getting any better at all. My knee itself is so stiff it feels tight and constricted, again it’s just not getting any easier. Please help please grateful for advice from similar . TIA

Jump to this post

I am at 8 weeks. Do you go to PT? I had a therapist I feel really overwork me and part of it was my fault as I didn't say anything. We did stairs, sit to stand, and 20 squats. The next day I was in tears and cried all through my next therapy appt. The therapist I had (who I like) is getting me back on track. I was told that you can backtrack and that the muscles need to learn again how to work because they were overworked. It is odd your incision is not healed yet. I do have two stitches trying to come up but that is normal I guess. I am taking 600 mg of Gabapentin at bedtime and Tizanadine (muscle relaxer) and it helps me sleep most of the time. Not last night..glutes, IT band and pain on the top of right foot. I'll ask about this today. But I can finally bend my knee again when I walk.

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willw | @willw | Nov 24, 2022

Yes...I had TKR 9 weeks ago. Knee seems okay. However, foot swelling and soreness make walking really difficult. I continue to need walker. I try cane on occasion, but my foot gets more sore when I do that. Frustrating indeed. I wonder if I should push it or rest my foot. PT says "You're in a pickle"

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willw | @willw | Nov 24, 2022

Yes ....me too....TKR on 9/16/22 the knee is coming around, however I can't walk due to swollen sore foot. My PT says I'm in a pickle. I never wanted to be in a pickle. #@%!!!!!!

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