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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@ray666

Hi, fourj (@fourj)

"Told them my symptoms, I guess they didn't think it was that serious. I knew it was."

That can be so damn frustrating. As patients, we're forever faced with choosing just the right words when speaking to our doctors: say too much, they may think you're exaggerating or gleaning exotic symptoms from Dr. Google; say too little, their minds may wander or think your symptoms are not all that serious. How to capture a doctor's attention? That is the challenge.

Years ago, I was in a play called Cold Storage. I played the younger of two patients who met every afternoon on the hospital sundeck. The older patient, who'd been in and out of hospitals for years, advised my character: "Make it sound interesting! When you tell a doctor what's bothering you, always make it sound interesting!" Those words have come back to haunt me in recent years. 😀

Ray (@ray666)

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After 10 months of suffering and getting my degree from the University of Google taught by Professor Google, I actually think I would be comfortable in surgery. We know that you have to be careful using medical terms that doctors haven't brushed up on recently. Drs don't like that. I found out the hard way. Just sayin.

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I had issues with my feet and had tingling and they hurt after a few hours of being on them. I'm curious if you have tried different shoes. I actually went from a Brooks women's 11b to a New balance men's 9 1/2 Extra wide and within a week of wearing them all my pain, tingling and walking issues resolved. For some reason I needed a bigger shoe after my TKR. Coincidence? I have no clue but just not the support and a wider shoe made huge difference for me. New shoes after a TRK can he a game changer because You are walking differently and the older ones are worn differently on the soles.

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I have spent thousands of $ on different shoes. I have New Balance ladies size 9 wide. I normally would wear size 8. They have like bumps on the insole, and I seem to be so sensitive to anything that is not smoothe.

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@pinsandkneedles

I have had two total knee replacements. The first (left) was in November 2022 and the second (right) was this past February. It has been a long haul getting over the pain and swelling and discomfort of my new knees BUT they are slowly progressing and getting better. The first surgery was uneventful but from the moment I woke up in recovery for the second replacement my right foot has been greatly effected. I have had more swelling in my right leg but that is getting better. As for my foot, I don't have any pain per se but it feels like I am walking on a sponge with my right foot. It has never been totally better but at times it is not as bad, but then it will get worse, feeling like it is swollen when it does not appear to be. The best I can describe it is it feels like I am walking on a sponge. I have tried gabepentin to no avail. Nothing seems to help. I am only seven months post surgery so I am hoping it will get better with time. My surgeon says the right foot issue must be coming from my back but it started immediately upon waking up in recovery from my knee replacement. I do have some degeneration in my back but no back pain. It must derive from the knee surgery somehow.

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I am 75 and 15 months post left TKR. Although the TKR is considered a success, my left foot hurt immediately after surgery and has continued to be problematic. Main foot discomfort was on the outside and on top of foot. PT said it would get better with time. It got better but still hurt. Then after I began walking a mile or so daily, I got a high grade tear in the plantar fascia 5 months post op. This has been a slow recovery, including weekly PT, but is finally getting significantly better. Outside and top of my foot still hurts if I do too much (like walking a mile and going to exercise class the same day). Surgeon says this has nothing to do with the TKR. DUH!! I am positive the mechanics of my foot changed from the surgery and has caused all of these issues. All I can hope is that over more time, my body will adjust to my new foot mechanics and pain will be gone. 🤞🏻

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@sma2day

Hi what kind of treatments did the psysiatrist offer you? Would like to hear success people are having with massage or PT or acupuncture ! Please help!

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I was dg 5 years ago with PD. I go for a deep tissue massage twice a month. I have a lot of problems with my feet and legs, be sure to find one that does deep tissue. The massage is not a relaxing massage but it sure helps. I am having knee problems and can not walk for exercise.

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Yes ditto. LTKR 12/2023.
L foot numb/ hypersensitive on bottom immediately and same or worse after 10 months postop. Impared gait. Tripping often. Can’t feel bottom of foot. Doctors are clueless.

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All who've posted about TKR post-op difficulties have me wondering about anesthesia. What sort of anesthesia were you given? My own TKR was more than a dozen years ago, long before I had problems with balance and gait (eventually leading to a PN diagnosis). Nonetheless, I did have some difficulty post-op: the anesthesia I'd been given (something like a spinal, but not exactly) to "deaden" my right leg from the hip down refused to "let go." I remember doctors from the ortho team coming to see me and looking puzzled. Fortunately, after an added two days in the hospital, my leg came back to life and I was able to leave. The posts here have got me thinking about anesthesia and its possible role in TKR post-op problems. ––Ray (@ray666)

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I was given a nerve block in my spine. Then anesthetic to knock me out. It must have been very lite because I woke up several times during surgery to the sound of a saw.

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" … to the sound of a saw." That's gruesome! I slept soundly throughout my TKR. It was only the next day, when the PT clinician arrived to get me up and out of bed and walking, that it was discovered I still had no feeling in the operated leg. Word spread through Ortho and a host of people wearing stethoscopes arrived to puzzle over my problem. (Note: MY problem,) The decision was made to "wait it out," and that night, at about 2:00 or 3:00 a.m., I awoke in excruciating pain: my leg! Of course, that was good news. I went home later that same day.

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Sounds like most ortho surgeons go by the same policy of never admitting guilt

My wife who is very healthy and vibrant required a TKR 5 months ago.

Her knee has been examined , x rayed and told that it’s perfect

However she’s suffered what she describes as a tight band around her knee that keeps her awake at night and basically avoiding doing much other than she’s doing every exercise available to help with the healing as well as resting, icing etc.

Past month or so she’s developed tingling in her toes on the TKR leg and numbness that comes and goes

Her surgeon promised her that it’s all part of the healing and prescribed an anti anxiety med to help her sleep which doesn’t seem to help

She was encouraged to get a second opinion and the other surgeon says it’s all normal an that it’ll take a year

When I asked him if she needed to seek pain management he obviously wasn’t listening to us because he said that it’s nit pai and that the tingling in her foot could be from her back which she never has had back issues and has no back pain which he replied that you don’t have to have back pain to have foot numbness

Finally went to my primary Doc and he is concerned enough that he’s ordered am MRI or cat scan along with urine and blood test

Like he said it’s better to figure it out now than wait

These surgeons I guess are just educated mechanics without any problem solving abilities other than to replace joints

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