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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@johnbishop

@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 have had several sessions of PT to no avail. Also had a new pair of orthotics since this all started. The burning is unbearable at times. Don’t know what else to do. No one wants to hear it.,..

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@mues

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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Hello @mues, Welcome to Connect. Thank you for sharing your experience and suggestions. I also wear hospital type socks at night to protect my feet when I have to get up in the middle of the night. Do you mind sharing how you found Connect?

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@kp6350

I have had several sessions of PT to no avail. Also had a new pair of orthotics since this all started. The burning is unbearable at times. Don’t know what else to do. No one wants to hear it.,..

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Have you tried Myofascial Release Therapy? There is a discussion you might want to read through to read the experiences of other members.

Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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I am 8 weeks post-op TKR–right knee. My femur was fractured during surgery. I have been in a lot of pain, especially at night, where I alternate sleeping between the bed and a recliner and use either an ice machine or heating pad, depending on what might make it more comfortable to sleep for short periods of time. I was up 5 times during last night and finally just got up for the day at 7:00 a.m. I also noticed, as soon as the block wore off in the hospital, a feeling there was a strap on the brace that went under my arch, or someone had left a large piece of tape under my arch. The numbness/pins and needles are now affecting the outer ankle and up the outside of my leg. The surgeon said maybe the brace was too tight. PT said maybe a pinched nerve. I do still have scar tissue under the incision which I massage for several minutes a day and I seem to be eliminating some of it, as the scar is looking less "puckered". I got to remove the brace 2 weeks ago. I need to use a cane (sometimes my walker) because the foot neuropaathy makes me off balance. Getting up, I can barely stand on my leg and have to try and stand by leaning against the couch and gradually standing upright with my cane. I am feeling a little less knee pain now, but it makes the foot even more annoying. When I wear socks around the house, my foot swells and the sock feels too tight. I wear my loosest shoes, and my foot swells and the one shoe is too tight within a few minutes. I have to wear flipflops a lot of the time but the straps feel too tight after an hour or so. I don't know if this will ever resolve, but I am pretty unhappy because I feel a femoral fracture was a bad enough surprise to wake up to! Oh, and the surgeon told me at second post-op when I asked if I could have a nerve conduction study if my foot still had problems at my next post-op visit, "No, you won't need that. Your foot should be better on its own", and when I asked, "When?", he said it might be a few months to a year, or it "could last forever". What?!!

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This is what I saw when I woke up in recovery

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Picture a few days after operation when bandage came off, foot is still numb after 18 months. Not much hope left for normalcy.

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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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I realize that your post is now almost three years old but I hope you see it. Wondering if the sensory problems you had following your TKR resolved over time. Your situation mirrors my own although mine is very recent. I am only seven weeks post op. I'm hoping that this is a time limited event but, as you noted, there seem to be no guarantees. Thanks in advance.

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Hi, I have this, from day 1. My ankle, big toe especially and walking is very tricky. Sorry to say no resolve from 1 year ago. Searching for correct diagnosis. I had a nerve block in the spine which has unfortunately made the other foot bad too… not as bad, just bad.
☹️

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I have foot pain, the bottom of both feet feel like the worse case of athletes feet you ever had.It did not just arise, I started out with simple bunion surgery, after 3 or 4 months of healing . I broke the big toe joint and the one next to it as well, the podiatrist called it a Liz Frank break. What ever that meant. I had plates and 13 screws added to my big toe joint and surrounding vicinity. After walking on it for 5 years or more I could not take the pain , 10 out of 10 every day . This is after a left hip replacement 1 year ago. Now I had asked after doing research my self to take the hard wear out . The Podiatrist said yes .
There was 4 hours of surgery , he said he got everything , except 1 screw. I thought my pain in the bottom of this foot was gone mostly . I thought I had Tarsal Tunnel . After 4 days , the numbing medicine is warring off and the pain is returning and it feels like it's blowing up again .
I have been staying of it , icing , , I do have a little more movement with my toes . I just want to be able to go to work and be happy during the day .
I came over to my computer to see if I could find were the surgeon mite have put the numbing medicine in my foot , when I fell on to this page .I thought I would share a little bit and se if any one could help with some experience.

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I wonder now about, the nerve pain in the bottom of my feet . Im almost ready for my knee replacement on the right side , a year ago they replaced my hip on the left side . Right after that I had severe pain on my left were it was 10 out of 10 from the middle of my back to my left to were the indentation on my butt cheek . Its your back ,its your back , its not my back .Tarsal tunnel ,Maybe ??? I had the hard-wear taken out of my foot, now the knee replacement , oh boy , I hope I can still walk. What does every one think , please let me know . Ok

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@glassguy3

I wonder now about, the nerve pain in the bottom of my feet . Im almost ready for my knee replacement on the right side , a year ago they replaced my hip on the left side . Right after that I had severe pain on my left were it was 10 out of 10 from the middle of my back to my left to were the indentation on my butt cheek . Its your back ,its your back , its not my back .Tarsal tunnel ,Maybe ??? I had the hard-wear taken out of my foot, now the knee replacement , oh boy , I hope I can still walk. What does every one think , please let me know . Ok

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Hello @glassguy3, Welcome to Connect, an online community where patients and caregivers share their experiences, find support and exchange information with others. As patients ourselves we can only share our experiences with you and not really provide medical advice. That said, If I read your first post correctly, it's only been 4 days since you had the hardware from your foot removed and I think the recovery will take a little more time.

The hardware looks similar to what is in my wife's left ankle which was severely broken several years ago. She asked about having it removed but the surgeon suggested leaving it alone since she doesn't have any associated pain in the ankle. Hoping some other members will be able to share their experience of recovery after having hardware removed from their foot.

Here's some information that you might find helpful — Benefits of Physical Therapy After Fracture Hardware Removal:https://www.verywellhealth.com/physical-therapy-after-fracture-hardware-removal-2696021

Have you discussed the pain with your surgeon to see if they have some suggestions?

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Yes I had it right out off surgery it has been 12week did the Dr do something wrong when he was in there.

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