Foot neuropathy after total knee replacement

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?

I have done well with my partial knee replacement other than bursitis with inflammation. It’s been 7 weeks.Now all of a sudden I have a awful burning sensation in my big toe and up the opposite side of the replacement! Has anyone else dealt with this.I was up most of the night with this. I have been told this could be nerve pain considering my knee on the right side is numb but what do you do for this type of pain?

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I have bylateral neuralgia, and plantar fibromatosis, befor sergery, now after my nerves in feet will not stop?

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I too experienced changes in the feeling of the souls of my feet after knee replacement surgery. For me, the sensations or feeling were like intense and continuous pins and needles in the souls of my feet. Taking off -and putting in – bed socks has helped but eight weeks after surgery, the sensations or feelings remain uncomfortable and at times, prevent sleeping.
Like the earlier correspondent, I have been advised (by my surgical team) that the discomfort may subside as time goes on, but they also said that the discomfort may never go away completely.
I do think that there seems to be a whole range of disability aspects that may remain after total knee surgery, which are not made plain before surgery. These various outcomes (ie. continuing numbness of areas around the knee, the aforementioned souls of the feet numbness and pins and needles sensations etc.,) should really be known, as possible outcomes, by patients, before surgery occurs.

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@jill31

I too experienced changes in the feeling of the souls of my feet after knee replacement surgery. For me, the sensations or feeling were like intense and continuous pins and needles in the souls of my feet. Taking off -and putting in – bed socks has helped but eight weeks after surgery, the sensations or feelings remain uncomfortable and at times, prevent sleeping.
Like the earlier correspondent, I have been advised (by my surgical team) that the discomfort may subside as time goes on, but they also said that the discomfort may never go away completely.
I do think that there seems to be a whole range of disability aspects that may remain after total knee surgery, which are not made plain before surgery. These various outcomes (ie. continuing numbness of areas around the knee, the aforementioned souls of the feet numbness and pins and needles sensations etc.,) should really be known, as possible outcomes, by patients, before surgery occurs.

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@jill31 – Welcome to Connect! So glad you joined the group. Like you, I had a TKR 8 weeks ago. I still have some numbness on the side of my knee – but my surgeon warned me that that might happen, and it is nothing like the pins & needles you are describing. That definitely sounds uncomfortable. I'm wondering if you get relief from your PT exercises. Sometimes, just doing 5 minutes or so on the stationery bike seems to loosen up my stiffness. My physical therapist says "motion is lotion" – so I try it when I'm having stiffness or discomfort.

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I am responding to Norby who reported foot neuropathy in Nov last year. If you see this reply, vould you please tell me how it has resolved from then? I had TKR 5 weeks ago in my right knee, have progressed great with my knee, over 120 degrees flexion and walking with one crutch or none, swelling not too bad. BUT I have incredibke numbness and pain in my right foot. It was teally bad and extended to my ankle when
I took the compression stockings off at night. Over a week ago, I was finally able to stop using those stockings, which I thought was the cause of it, but the numbness is getting worse slthough the psin is less. It is limiting me from using the bike to under 15 minutes because the foot gets so numb and then painful as I pedal, so now it is getting in the way of my knee recovery. I saw the surgeon a month post op, he would not even let me describe what was going on and saifpd right away, "nothing to fo with the knee". I have function and movement of my foot and when he pinched between the toe reakky hard I cohkd feel it. So have you learned anything and could you please share what might be happening? I am really scared.

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@irol

I am responding to Norby who reported foot neuropathy in Nov last year. If you see this reply, vould you please tell me how it has resolved from then? I had TKR 5 weeks ago in my right knee, have progressed great with my knee, over 120 degrees flexion and walking with one crutch or none, swelling not too bad. BUT I have incredibke numbness and pain in my right foot. It was teally bad and extended to my ankle when
I took the compression stockings off at night. Over a week ago, I was finally able to stop using those stockings, which I thought was the cause of it, but the numbness is getting worse slthough the psin is less. It is limiting me from using the bike to under 15 minutes because the foot gets so numb and then painful as I pedal, so now it is getting in the way of my knee recovery. I saw the surgeon a month post op, he would not even let me describe what was going on and saifpd right away, "nothing to fo with the knee". I have function and movement of my foot and when he pinched between the toe reakky hard I cohkd feel it. So have you learned anything and could you please share what might be happening? I am really scared.

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Hi @irol and welcome to Connect. I have had two TKRs and never had a problem like yours, and I do not recall anyone on Connect with a similar problem in a foot. Have you called your doctor about it? Hopefully, if you do he/she will be able to shed some light on what the problem is, if it's a temporary healing type of thing, or if there is something he/she can do to help you.

I am sorry you are going through this, but hopefully someone here on Connect might have had a similar experience with a TKR.
JK

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I had total right knee replacement 2.12.2019. Right after getting to my room I noticed my foot was numb yet tingly with a lot of pain in foot that shot through my whole body and had a lot of pain in my knee. I knew this was not normal as i had my left knee 5 years prior and did not have a numb tingly foot or the extreme pain in the knee. Never took anything more than Tylenol. Now i was taking nocor with no pain relief. So they added deloted in my iv. Still no pain relief. When the Surgeon visited the next day he just brushed it off. Hospital dr. said he had no clue and blamed it on diabetes ( i am recently diagnosed). At PT i could not do the exercises because flexing the foot now caused pain in the calf. They did ultrasound for blood clots, none found. When i tried to put weight on the foot/leg, my knee buckled. So they put a stabler on that leg which ment my leg was stiff so i could stand. 4th day after surgery i went home with numb tingly foot and pain killers which i had to refill and the get a different pain killer because nothing helped the pain and i wasn't sleeping. Went to PT and got a good bend 135% and 90% flat by my ck up. Went for followup 2 1/2 week checkup with surgeon and was just told foot numbness and tingly could be from nerve block after surgery for knee pain or tourniquet to the thigh during surgery.
Not satisfied with that i went to my endocrinologist to make sure it was not from diabetes. She confirmed that it would be both feet if from diabetes. She set me up with an appointment with a family practice dr. (primary not available, she was her associate). At that appointment she thought it could be a blood clot or damage to my circulation in my legs, since PT could feel lumps in calf. She did prescribe gabapentin to help with the pain , numbness, tingling in foot. It did help lessen the systems, but did not get rid of it totally., but can at least sleep better. Again ultrasound showed no blood clots, but she also ordered an ABI to check for circulation pressure. This showed the pressure on that right leg from the knee down is half what it should be. This news sent me to the cardiologist who didn't think it was circulation but numbers don't lie. I was then scheduled for an angiogram. This proved the main artery from my knee down was NOT receiving ANY blood flow. So sent to a surgeon who works with veins. He did not want to say it was diffently from my knee replacement, but more than likely was something that happened during knee surgery. So i am now set up for yet another surgery to fix the vein in the back of my knee. I have also been set up with a neurologist incase it was nerve damage. The surgeon thought it could be both. But my new knee has multiple clicks so hurts when it clicks when i walk. So when i get done with the vein surgery and see if there is nerve damage, i am going back to the doctor who did my knee.
I am still taking tramadol at bed time and IB/Tylenol or naproxen/Tylenol during the day for pain. The calf has lost most of its muscle so it tires after a few steps. My bend has gone backwards to hardly 90% flat is less as well. Was able to go up and down stairs normally. NOT any more.
Hope this info helps. We have to advocate for ourselves.

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@irol

I am responding to Norby who reported foot neuropathy in Nov last year. If you see this reply, vould you please tell me how it has resolved from then? I had TKR 5 weeks ago in my right knee, have progressed great with my knee, over 120 degrees flexion and walking with one crutch or none, swelling not too bad. BUT I have incredibke numbness and pain in my right foot. It was teally bad and extended to my ankle when
I took the compression stockings off at night. Over a week ago, I was finally able to stop using those stockings, which I thought was the cause of it, but the numbness is getting worse slthough the psin is less. It is limiting me from using the bike to under 15 minutes because the foot gets so numb and then painful as I pedal, so now it is getting in the way of my knee recovery. I saw the surgeon a month post op, he would not even let me describe what was going on and saifpd right away, "nothing to fo with the knee". I have function and movement of my foot and when he pinched between the toe reakky hard I cohkd feel it. So have you learned anything and could you please share what might be happening? I am really scared.

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I just posted a lenghly post of my numb tingly foot after knee replacement. Incase you can't find it have an ABI done on your legs. I had it done and it proved th main artery from the knee down is NOT getting any blood flow and i was set up with a surgeon who fixes veins.
I hear you are scared and so am i and could not quit until i found out what was going on.
The surgeon who did my knee just brushed it off.
Now i know it is circulation and i also have appointment with nerology to check on nerves.

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@gator1965

Well the surgeon discharged me, he was happy with the flexion being between 96 to 100 degrees. My pain he says is neuropathic, and will take a while to resolve.

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Ask for an ABI that looks for blood flow below the knee. They found that was my prob with my numb tingly foot

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@norby

Thanks for your reply and referral to an interesting article. My surgeon does not believe that I have had nerve damage because I have good motor function. However, she does think that nerve compression from swelling is probably causing this. And that’s why she thinks this will “probably” improve with time. But there is always the qualifier that it may never get better.

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@norby I am new and learning how to post things. Please see a post i made that i did not mention to anyone. I got the numb tingly foot prob after right TKR found out from an ABI i have no blood flow from tne back of my knee to my foot. I am scheduled for surgery to have the vein fixed. Surgeon said it could also be nerve damage so i have appt with nerology too. But hope after i get blood flow back it solves at lest park of the prob. Will post after vein surgery on April 10th.

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@loriaakre

@norby I am new and learning how to post things. Please see a post i made that i did not mention to anyone. I got the numb tingly foot prob after right TKR found out from an ABI i have no blood flow from tne back of my knee to my foot. I am scheduled for surgery to have the vein fixed. Surgeon said it could also be nerve damage so i have appt with nerology too. But hope after i get blood flow back it solves at lest park of the prob. Will post after vein surgery on April 10th.

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Hi, @loriaakre and welcome to Connect.
I am so glad you were able to find a reason for your numbness. Sounds like you had a good doctor for him/her to have found the problem. I hope the surgery goes well, and perhaps you won't need anything further with a neurologist too.
Keep in touch. I had no problem like this after either of two TKRs, but it does seem as if you are not the only one who has. That's really valuable information for people to consider who do have similar problems.
JK

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@loriaakre

I had total right knee replacement 2.12.2019. Right after getting to my room I noticed my foot was numb yet tingly with a lot of pain in foot that shot through my whole body and had a lot of pain in my knee. I knew this was not normal as i had my left knee 5 years prior and did not have a numb tingly foot or the extreme pain in the knee. Never took anything more than Tylenol. Now i was taking nocor with no pain relief. So they added deloted in my iv. Still no pain relief. When the Surgeon visited the next day he just brushed it off. Hospital dr. said he had no clue and blamed it on diabetes ( i am recently diagnosed). At PT i could not do the exercises because flexing the foot now caused pain in the calf. They did ultrasound for blood clots, none found. When i tried to put weight on the foot/leg, my knee buckled. So they put a stabler on that leg which ment my leg was stiff so i could stand. 4th day after surgery i went home with numb tingly foot and pain killers which i had to refill and the get a different pain killer because nothing helped the pain and i wasn't sleeping. Went to PT and got a good bend 135% and 90% flat by my ck up. Went for followup 2 1/2 week checkup with surgeon and was just told foot numbness and tingly could be from nerve block after surgery for knee pain or tourniquet to the thigh during surgery.
Not satisfied with that i went to my endocrinologist to make sure it was not from diabetes. She confirmed that it would be both feet if from diabetes. She set me up with an appointment with a family practice dr. (primary not available, she was her associate). At that appointment she thought it could be a blood clot or damage to my circulation in my legs, since PT could feel lumps in calf. She did prescribe gabapentin to help with the pain , numbness, tingling in foot. It did help lessen the systems, but did not get rid of it totally., but can at least sleep better. Again ultrasound showed no blood clots, but she also ordered an ABI to check for circulation pressure. This showed the pressure on that right leg from the knee down is half what it should be. This news sent me to the cardiologist who didn't think it was circulation but numbers don't lie. I was then scheduled for an angiogram. This proved the main artery from my knee down was NOT receiving ANY blood flow. So sent to a surgeon who works with veins. He did not want to say it was diffently from my knee replacement, but more than likely was something that happened during knee surgery. So i am now set up for yet another surgery to fix the vein in the back of my knee. I have also been set up with a neurologist incase it was nerve damage. The surgeon thought it could be both. But my new knee has multiple clicks so hurts when it clicks when i walk. So when i get done with the vein surgery and see if there is nerve damage, i am going back to the doctor who did my knee.
I am still taking tramadol at bed time and IB/Tylenol or naproxen/Tylenol during the day for pain. The calf has lost most of its muscle so it tires after a few steps. My bend has gone backwards to hardly 90% flat is less as well. Was able to go up and down stairs normally. NOT any more.
Hope this info helps. We have to advocate for ourselves.

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Thsnk you for your long response. I hope the surgery goes well and I will wait and see how it resolves fir you. When I came out of TKR surgery, my foot and ankle were extremely painful, like a truck was sitting on it, and felt like soneone had twisted it all the way around. Noone would tell me what was going on, and rhe nurses pur ice packs on it and forgot about it until my leg got cold burned. So I worked hatd at PT at home, am on bike 15 minutes, high resistance, over 120 flexion, but my foot feels like someone tied a string around some othe toes and numb on bittom. It is iff and on but really bad at night and kerps me from sleeping because it gets really painful. I have an apptment with GP to see what she tecommends as a specialist. I was extremely active 6 months before my surgery and still in really good shape, muscle tone, etc., no medical problems. I had the KR so I can enjoy cycling again, but if I have a painful foot, I can't even wear a sneakwr for a half hour without extreme pain. The surgeon dismissed it and said it was probably a back problem. I have never had, and don't have a back problem, as far as I know. It just seems like doctors deny things instead of being curious to look into it.

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Hi I had a right total knee replacement about 8 months ago and had numbness right away to the heel and right half of the bottom of the foot including my 4 and 5 baby toe
I asked my surgeon about it and he couldn’t explain why just that it can happen . He said it will take a while to improve and said the nerve comes back about a millimeter a day . I have had improvement but my heel has less feeling and my toes are over sensitive so I choose my shoes carefully and I am totally back to all activity as tolerated I have just found that the calf gets tired quickly and have to just work through it on walks . I did take nortryptiline for nerve pain instead of gabapentin less side effects and only needed it for a few weeks . My best advice is after 4 weeks get into physio in the pool. Walking against current in a lazy river and doing lunges etc. feels so much better than at physio . I was kicked out of physio at 6 weeks for doing to much but I still do the pool I will check back in a bit and let you know if the numbness resolved by 12 months or not . One recommendation is to get a crocus for the knee post surgery. Here in Canada it is mandatory to bring with you and it goes on right after surgery I used it all the time I was resting and it helps with the pain tremendously about 200 dollars. It is like Cooler filled with ice and water and it pumps through the knee cuff and doesn’t have a time limit like ice it is just circulated cold water

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@juliesknee

Hi I had a right total knee replacement about 8 months ago and had numbness right away to the heel and right half of the bottom of the foot including my 4 and 5 baby toe
I asked my surgeon about it and he couldn’t explain why just that it can happen . He said it will take a while to improve and said the nerve comes back about a millimeter a day . I have had improvement but my heel has less feeling and my toes are over sensitive so I choose my shoes carefully and I am totally back to all activity as tolerated I have just found that the calf gets tired quickly and have to just work through it on walks . I did take nortryptiline for nerve pain instead of gabapentin less side effects and only needed it for a few weeks . My best advice is after 4 weeks get into physio in the pool. Walking against current in a lazy river and doing lunges etc. feels so much better than at physio . I was kicked out of physio at 6 weeks for doing to much but I still do the pool I will check back in a bit and let you know if the numbness resolved by 12 months or not . One recommendation is to get a crocus for the knee post surgery. Here in Canada it is mandatory to bring with you and it goes on right after surgery I used it all the time I was resting and it helps with the pain tremendously about 200 dollars. It is like Cooler filled with ice and water and it pumps through the knee cuff and doesn’t have a time limit like ice it is just circulated cold water

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Hi @juliesknee – Welcome to Connect! You certainly shared some great information. I've had 2 TKRs – the most recent in January of this year – and I had never heard of the crocus. Can you share more about what you do in the pool? Is it mainly walking or also exercises? I'm getting ready to start going to the pool and that will be an incentive!

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