Calf pain after TKR

Posted by afladland @afladland, 4 days ago

I am 5 weeks post op from TKR on my right knee. From the very 1st week, most of my pain is in my calf. It seems to be getting worse with every week. It is especially painful when I am sitting or driving. The only thing that gives me immediate relief is when I get in a hot bath. At my 4 week check up, I have virtually no swelling and my ROM is where its suppose to be. It is such a deep ache in my calf with numbness in my foot. Ultrasound showed no blood clot. I've been from my surgeon to a vascular specialist and now referred to a neurologist. Has anyone had this issue?

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

Hello @afladland, Welcome to Connect. I'm sorry to hear you are dealing with the calf pain and numbness in the foot following your knee replacement. I think it's still early in your recovery and it sounds like you are doing OK except with the calf pain and numbness in the foot. I had pain around the knee following my TKR but did not experience the pain or numbness you have. While we wait for other members to respond with their experience, I thought I would share this Mayo Clinic page that may be what you are experiencing.

"Mayo Clinic is investigating infrapatellar saphenous nerve neuroma as a source of pain after total knee arthroplasty. About 20% of patients who have a total knee arthroplasty are dissatisfied with the result, often due to residual pain. "
— Saphenous nerve neuroma after total knee arthroplasty:
https://www.mayoclinic.org/medical-professionals/orthopedic-surgery/news/saphenous-nerve-neuroma-after-total-knee-arthroplasty/mac-20482753.
You may also find the following article on the topic helpful.
"Neuropathic pain is an underestimated problem in patients with pain after TKR. It peaks at between six weeks and three-months post-operatively. However, from these data we were unable to predict which patients are most likely to be affected."
— The natural history of pain and neuropathic pain after knee replacement:
https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.96B9.33756.
When is your appointment with the neurologist? Can you let us know what you find out?

REPLY

I also experience extreme calf pain following my TKR and then several weeks after surgery. Speaking with my Nurse Navigator she had me continue with gabapentin 3x a day with tizanidine every 6 hours/as needed. This regiment truly kept the situation manageable as it twindled down to nothing. The Nurse said some people just experience severe muscle spasms which need longer term attention. I hope you and your health team can come to a good working solution as I know this is extremely painful. Best regards.

REPLY

I have calf pain the first few months and I take 600mg Gabapentin at bedtime (I took before surgery as well) an Tizanadine 4mg as needed. I don't take the Tizanadine much anymore and the calf pain has subsided. My issue is when I do to much I have shin pain. I am 16 weeks out and quite active. I still have thigh pain as well that hopefully is subsiding soon. Sometimes too when I do to much my feet tingle if I'm in the recliner but then stop when I'm in my bed. It's definitely a process. I wish I could get a bath but I can't lift my leg over the tub as of yet. Did they give you any medication to help?

REPLY

I had severe calf pain post op and while the ultra sound did not show any blood clots it did reveal that I have a Baker’s cyst.
Although I still have swelling in my knee the calf pain has decreased significantly.

REPLY

I am one year post Tkr For the past few months I experience calf pain usually accompanied by back of knee pain and heel pain. Yesterday my heel felt numb instead of pain. I occasionally have significant stiffness and believe I have lost some bend. In October my surgeon checked out the knee and the tkr results were fine. He didn’t offer much help about my pain other than discuss it with my PT. Lately the pain in calf and back of knee is worse and keeping me from much exercise and walking is not easy. I’ve read the Mayo articles on the possible nerve issue and may try to get an appt with a neurologist. Overall I think the knee itself is good but so far I’m not better off in general than before tkr.

REPLY

I had pain immediately after surgery Sept '19. Several ultrasounds for blood clots, none. Test for peripheral artery disease, negative so then more PT in 2021. It did not help. CT scan-negative. Finally saw a Neurologist and I am having a nerve conduction study!

REPLY
@loreleiks

I also experience extreme calf pain following my TKR and then several weeks after surgery. Speaking with my Nurse Navigator she had me continue with gabapentin 3x a day with tizanidine every 6 hours/as needed. This regiment truly kept the situation manageable as it twindled down to nothing. The Nurse said some people just experience severe muscle spasms which need longer term attention. I hope you and your health team can come to a good working solution as I know this is extremely painful. Best regards.

Jump to this post

Doctor did not tell me to taper off gabapentin after 6 months of being on it. It was an awful withdrawal! Severe headaches and ill feeling. Called them so then tapered but it took me forever to start feeling better!!

REPLY

Continual knee, calf, and foot pain for almost 2 years post TKR. Nerve conduction study shows issue with my deep Peroneal Nerve so having a special MRI to focus on nerve. Physiatrist said if something is pressing on it there may be something that can be done. But, it may be something only treatable with meds. Just not sure what to think or feel at this point.

REPLY
@loreleiks

I also experience extreme calf pain following my TKR and then several weeks after surgery. Speaking with my Nurse Navigator she had me continue with gabapentin 3x a day with tizanidine every 6 hours/as needed. This regiment truly kept the situation manageable as it twindled down to nothing. The Nurse said some people just experience severe muscle spasms which need longer term attention. I hope you and your health team can come to a good working solution as I know this is extremely painful. Best regards.

Jump to this post

Do you remember if it was more painful when you were sitting or driving? I can't drive more than 5 minutes and my calf/foot is screaming at me.

REPLY

My spasms weren't predictable.

REPLY
Please sign in or register to post a reply.