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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@amandajro

Hello @walleybe and welcome to Mayo Clinic Connect. You will notice I've moved your post into an existing discussion on foot pain following TKR, which you can find here:

- Foot neuropathy (numbness and pain) after total knee replacement (TKR): https://connect.mayoclinic.org/discussion/foot-neuropathy-after-total-knee-replacement/

I see @denhyg1run and @flaredhead have both joined you, so will let you connect with them!

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Yes, I had a TKR in 2014 and a total knee revision in 2017 and have numbness in my foot.

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@johnstacy123

Yes, I had a TKR in 2014 and a total knee revision in 2017 and have numbness in my foot.

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neuropathy, after tkr, is ( unfortunately) normal albeit surgeons, in general, won't share that. i'm two weeks into my second tkr but my surgeon was very clear that neuropathy is definitely possible after tkr. for me, taking a gabapentin at night to sleep isn't a bad trade-off for the ability to be mobile again without pain. a lot of this can be mental if you allow it to go down that path. i learned to accept and move on.
good luck.
vince

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In June of 2020 I had double TKR and since that time the neuropathy in both feet is getting progressively worse. In general, if I am up and moving the symptoms are not so severe that they influence my gate. However, if I have been seated for a period of time my feet and lower legs get so numb that upon standing I have to be sure my feet are under me. Accompanying ankle pain is making mobility difficult when first rising. No signs of improvement to date.

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@vinran

neuropathy, after tkr, is ( unfortunately) normal albeit surgeons, in general, won't share that. i'm two weeks into my second tkr but my surgeon was very clear that neuropathy is definitely possible after tkr. for me, taking a gabapentin at night to sleep isn't a bad trade-off for the ability to be mobile again without pain. a lot of this can be mental if you allow it to go down that path. i learned to accept and move on.
good luck.
vince

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Good advice on the gabapentin. I think surgeons need to broaden their knowledge about post op TKR nerve pain
I know that has been an issue with me and Lyrica was a life changer for me ( it was my family doctor who got me on the right dose for pain management. Interestingly enough he had a hip replacement a couple of months before my TKR so I think he was a little more empathetic

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@billjan1950

My issue with my TKR in the left knee, is not pain. What I have is numbness and a hit of tingling on the top of my left foot above the ankle, and a little bit at the knee itself. As I mentioned earlier, it has been exactly one year since the surgery. I know that nerves take quite a while to heal and I'm hoping that this is simply part of the healing process. I am 78 years old as I said and have type 2 diabetes, but my blood sugar is pretty much under 7 on the A1c. I'm trying to find out if anyone has experience prolonged numbness or tingling. I was checked by the surgeon about six or seven months after the operation and he said things were looking very good, but I know that nerves can be damaged. My concern is that this is not diabetic neuropathy oh, but I'm thinking it's connected to the knee because prior to the surgery I had no problems in my left foot whatsoever. Hopefully someone out there can give me some encouragement or some answers. Thank you very much.6

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I had tingling like that before TKR...I was told it originated in my back. 6 months out and I'm coping fairly well. The neuropathy feeling still occur. Like back pain in comes and goes...good luck

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Trying to sort out if neuropathy in my foot is from TKR or back. Knee and leg has burning pain. Back and buttocks deep pain. EMG shows Peroneal nerve damage. MRI this week. Anyone with similar issue and advice on how to sort out? No more treatment until I have a better confidence pain generator is determined!

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@loriaakre

14 months out and still have clicking. Knee wants to give out sometimes while just standing and numb foot. Wad told same thing give it a year. Then told 2 years now 3 years. But my numb foot came from the popliteal artery being pinch off during TKR. Finally my primary said it's not normal. I had surgery on the artery. Then had nerve testing done which showed nerve damage. My back had also been giving me new issues. Had a steroid injection in my back and that surgeon told me my TKR surgeon pinched more than my artery. It is never a Drs fault! Or at least that they will admit to.
Good luck

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I had tkr’s first one 6 plus yrs ago. Developed numbness in balls of feet and first 3 toes on both feet even though only right knee replaced. PT seemed to help and prob went away. 19 months later ( 5 yrs ago now) has left knee done. A week later problem redeveloped. That was 5 plus yrs ago. To this day both feet numb, burning, and stiff. Motor function good in both feet other that ankle pain from both feet being flat. Wear custom orthotics constantly and have had 3 nerve decompression surgeries on my left foot being worse. Left foot also more flat than right. I suffer every single day. 24/7. Gabapentin 600 mg 3x helps a tad but not enough. No one has any answers for me. I need HELP. Anyone with any suggestions?

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@kp6350

I had tkr’s first one 6 plus yrs ago. Developed numbness in balls of feet and first 3 toes on both feet even though only right knee replaced. PT seemed to help and prob went away. 19 months later ( 5 yrs ago now) has left knee done. A week later problem redeveloped. That was 5 plus yrs ago. To this day both feet numb, burning, and stiff. Motor function good in both feet other that ankle pain from both feet being flat. Wear custom orthotics constantly and have had 3 nerve decompression surgeries on my left foot being worse. Left foot also more flat than right. I suffer every single day. 24/7. Gabapentin 600 mg 3x helps a tad but not enough. No one has any answers for me. I need HELP. Anyone with any suggestions?

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Correction second knee done 9 months not 19 months after 1st

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@rennie

Trying to sort out if neuropathy in my foot is from TKR or back. Knee and leg has burning pain. Back and buttocks deep pain. EMG shows Peroneal nerve damage. MRI this week. Anyone with similar issue and advice on how to sort out? No more treatment until I have a better confidence pain generator is determined!

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I had right TKR done 4 years ago. when I came out of surgery my leg from knee to toes was totally numb. was told normal. it wasn't, my surgeon pinched the popliteal artery behind my knee and I had no blood flow from the knee down. I had purple toes and a cold foot.
It took my primary to order and ABI test which if blood pressure of your legs. Very little pressure, had angiogram done and she couldn't go any further that behind that right knee. had to have surgery to open the artery. It was 2 months without blood flow to foot. I have some cell and tissue damage which has left some numb spots on bottom of foot and 3 of my toes. They tried to blame it on my back at first, but it wasn't . Went back to surgeon who did my knee and all he said was why did you wait so long to get it fixed you could of lost your leg. I saw him 3 times before I had artery surgery and all he ever said was it was normal to have nerve damage. Good Luck It's hard to find someone to listen and do something about it.
Lori

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@continentalred

Good advice on the gabapentin. I think surgeons need to broaden their knowledge about post op TKR nerve pain
I know that has been an issue with me and Lyrica was a life changer for me ( it was my family doctor who got me on the right dose for pain management. Interestingly enough he had a hip replacement a couple of months before my TKR so I think he was a little more empathetic

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May I ask what they gave you....I currently take 900 mg of Gabapentin at bedtime., I have tingling in my feet when I am in a reclining position too long. Frustrating. My surgeon only wants to see me anymore if I have an actual issue with my knee. Thanks for any info.

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