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?

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@judylibb

I had the right knee done in 2006 and the left in 2007. I started having symptoms in my right leg shortly after surgery and was told it would go away. It never did and progressed to my foot. Then I got numbness in my left leg/foot and went to a neurologist in 2011. I am currently taking 300MG 4 times a day.

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Hi @judylibb, I've had my right knee replaced and I also have neuropathy in my feet and just above my ankles but it was there before my knee replacement. My surgeon still went through all the risks and explained that neuropathy is one of them from complications. Sorry to hear you are having pain also with your neuropathy. I think there are several things that may help that you may want to discuss with your surgeon or doctor. There really is no cure for neuropathy unless you have a compressed or damaged nerve that can be fixed with surgery (my non medical opinion). As a fellow member with neuropathy I think our best option is to find something that provides relief from the symptoms.

You might find the following article helpful — Mayo Clinic Q and A: Pain after knee replacement surgery: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-pain-after-knee-replacement-surgery/

You might also find the following discussion helpful as it covers pain from many conditions — Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Have you discussed any alternatives to your current pain medication with your neurologist or doctor?

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No we haven't discussed that yet. I just recently became a member of the Foundation for Peripheral Neuropathy ( FPN). They offer support and guest speakers on line.

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Yes, 21/2 years now. Never has gone away and often is really bad in my foot and leg.

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@gator1965

I am nearly 8 months following my total knee replacement. I have a neuropathic type of pain which has been present since the replacement. I have a numbness and tingling type sensation which is constant, and i cannot bear anyone or anything touching this part, it sends out a shooting type of pain. Initially I could not even have a sheet over it. I also have a burning type of pain down my leg. My physio recommended that I try different textures rubbing the knee to desensitise the area from towel, tissue to toothbrush! I haven't tried the toothbrush yet!!
I do still experience swelling to the leg
My surgeon prescribed baclofen and amitriptyline at night. My GP is still juggling the dosages around, and I am still taking regular paracetamol and brufen.

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Hello I also had knee replacement surgery over 2 months ago ! Now my toes don't move I had a nerve test done! Don't know anything yet! I can't hardly walk at all something happened I know it did ! Idk what to do anymore with any suggestions??

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Hi.

I had the right knee in January 2021. Pain was horrible for a couple months. I started PT right away and was finally able to walk on the road starting with a 1/4 mile or so. In April, I got up to 2 miles or more and then I began getting horrible burning and numbness in both feet. The doctors at hospital said it was PN or diabetic neuropathy and offered no help or solution. Ended up going to a neurologist at another hospital and they did Small and large nerve test and no evidence of nerve damage. The neurologist suggested PT for spinal stenosis symptoms. I’m doing the McKenzie Method. I am having some relief but cannot walk more than 1 mile without my feet exploding after walking and then sitting down. Before my knee surgery and blowing out my knee, I use to walk at least 3 miles a day with any burning or numbness in my feet. Walking would help make any foot discomfort I may have had. After the about 2 or so weeks after the surgery, my entire groin and genital area became numb. The doctors or PT persons did not care and dismissed this. I would take a hot shower and area would become numb. The numbness has gone away there but I have increased loss of sensitivity and function sexually. I think my surgical knee(Leg) is longer now than the other. I asked the new PT person and she said it’s because of the hip, or something like that. Regardless, I have severe pain, burning, numbness in both feet now, and didn’t till my knee replacement and after I started walking again. Anyone have any insight. I keep getting patronized when I try to address my issues with the original hospital. Thanks.

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@ljn

I see that gabapentin was prescribed for knee replacement patients who seem to present with nerve damage pain. My surgeon prescribe gabapentin from day one after surgery. But he did not prescribe this drug for any other of his knee replacement patients that I know. So I asked him why…and he said for pain. When I wanted to have the conversation about nerve involvement he refused. I did and three years later still do suffer nerve pain in my leg and ankle. The surgeon told me it was my heart. It was not. I sure could use a new right knee, but will not have it done. Better the pain I know than a worse situation like I have now.

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Was your operation at a teaching hospital?

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Still have it after 2 1/2 years and it is constant and worse at night. But my surgeon says it's not a result of his surgery. He did prescribe gabapentin from the get-go, as part of my go home medications, and the only medication I was to take on a three times a day schedule…but of course he still proclaimed that he saw not indication of nerve involvement with his work! I researched gabapentin and thought the side effects to be very risky and since my surgeon said there was no nerve involvement, I could not see why I should take it. He said…then don't!

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@ljn

Still have it after 2 1/2 years and it is constant and worse at night. But my surgeon says it's not a result of his surgery. He did prescribe gabapentin from the get-go, as part of my go home medications, and the only medication I was to take on a three times a day schedule…but of course he still proclaimed that he saw not indication of nerve involvement with his work! I researched gabapentin and thought the side effects to be very risky and since my surgeon said there was no nerve involvement, I could not see why I should take it. He said…then don't!

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Do an ABI test (pressure test for your legs) that is what I had done that found the knee surgeon pinched off the popliteal artery behind my knee and that the numbness was from no blood flow from my knee down. I am 2.5 years out and still have some tingling and numbness in my foot and it gets cold easily and hurts. But since I went almost 60 days before the artery was surgically opened I have some permanent damage to cells and tissue. When I told my knee surgeon what he did and asked why he keep saying it was normal he said and I'll never forget "Why did you wait so long to get it fixed you could of lost your leg" It was my primary that said it was not normal and ordered the ABI which showed little pressure in that leg.

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I posted about my experience and what caused my foot numbness tingling and pain. Pinched popliteal artery. have an ABI test done,

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@johnbishop

Hi @judylibb, I've had my right knee replaced and I also have neuropathy in my feet and just above my ankles but it was there before my knee replacement. My surgeon still went through all the risks and explained that neuropathy is one of them from complications. Sorry to hear you are having pain also with your neuropathy. I think there are several things that may help that you may want to discuss with your surgeon or doctor. There really is no cure for neuropathy unless you have a compressed or damaged nerve that can be fixed with surgery (my non medical opinion). As a fellow member with neuropathy I think our best option is to find something that provides relief from the symptoms.

You might find the following article helpful — Mayo Clinic Q and A: Pain after knee replacement surgery: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-pain-after-knee-replacement-surgery/

You might also find the following discussion helpful as it covers pain from many conditions — Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Have you discussed any alternatives to your current pain medication with your neurologist or doctor?

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Hi. I had a tkr on my right knee and three months later felt numbness in both my feet. So I don’t think it was anything the surgeon did. Seem to subside. Move on to 10 months later my left knee Done and 2 weeks later both feet went numb in the balls of my feet and toes. Seems it may be my gait with my flat overpronated feet after surgery. Decompression on the tarsaltunnel 3 times. Nothing changed. Very debilitating 3-4 yrs later…. 😪😪

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@kp6350

Hi. I had a tkr on my right knee and three months later felt numbness in both my feet. So I don’t think it was anything the surgeon did. Seem to subside. Move on to 10 months later my left knee Done and 2 weeks later both feet went numb in the balls of my feet and toes. Seems it may be my gait with my flat overpronated feet after surgery. Decompression on the tarsaltunnel 3 times. Nothing changed. Very debilitating 3-4 yrs later…. 😪😪

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@kp6350 I'm sorry to hear nothing has seemed to help your pain and numbness. You mentioned your gait may have something to do with it. Have you discussed your gait with your doctor to see if there may be physical therapy or other options to help with that?

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I am 72 and 4th day post 2nd TKR. The first one went fine a number of years ago. I am specifically addressing the neuropathy. I have had post-chemo neuropathy for over 10 years. There are a variety of drugs you can try.
i tried Gabapentin which knocked me out. I tried Lyrica which worked pretty well but made me feel drunk. The antidepressant Cymbalta is approved for neuralgia pain. I take Effexor XR which is another SNRI for depression. I took it years ago and stopped it once. My feet were so tender I could barely walk and went back on it. If neuropathy is impacting your balance, there are PT centers that specialize in balance therapy. I wear the hospital type socks at home constantly. They have a variety on Amazon. Make sure the backs of your heels are covered in any footwear. I have had a lot of falls and 2 TBIS due to my neuropathy. Started using a small crossbody purse for better balance and to keep my hands free. A pain clinic is a good place to go as they are usually persistent. Best of luck.

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