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

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In January of 2020 I had my second knee replacement . The left leg was done and 6 weeks later I had severe pain at the back and left of my ankle. Several months later after prednesone and pt my knee surgeon gave me a corizone shot in the ankle. two days later the pain went away. Then in February of 2021 it came back. went to get cortizone shot and they said they can't do them anymore they are to dangerous. went to an ankle specialist and he said the same thing. Starting pt for gentle stretches and I am in an aircast boot. That is doing a terrible number on both my knee replacements. Any suggestions what I can do for my knees since they are stiff and painful.

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@janicemmccarthy

In January of 2020 I had my second knee replacement . The left leg was done and 6 weeks later I had severe pain at the back and left of my ankle. Several months later after prednesone and pt my knee surgeon gave me a corizone shot in the ankle. two days later the pain went away. Then in February of 2021 it came back. went to get cortizone shot and they said they can't do them anymore they are to dangerous. went to an ankle specialist and he said the same thing. Starting pt for gentle stretches and I am in an aircast boot. That is doing a terrible number on both my knee replacements. Any suggestions what I can do for my knees since they are stiff and painful.

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@janicemmccarthy I am sorry you are dealing with ankle pain and complications post-surgery.

I wanted to share the following information to see if it would be helpful to you based on your experience.

– Correlation of knee and hindfoot deformities in advanced knee OA: compensatory hindfoot alignment and where it occurs:
https://pubmed.ncbi.nlm.nih.gov/25024033/
Does any part of that information help or sound familiar?

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@amandajro

@janicemmccarthy I am sorry you are dealing with ankle pain and complications post-surgery.

I wanted to share the following information to see if it would be helpful to you based on your experience.

– Correlation of knee and hindfoot deformities in advanced knee OA: compensatory hindfoot alignment and where it occurs:
https://pubmed.ncbi.nlm.nih.gov/25024033/
Does any part of that information help or sound familiar?

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I have been to the knee surgeon, spine specialist and ankle specialist. No one has mention anything in the article. Ankle specialist boot me in a boot and said see you in 4 weeks. Night pain is so severe that I mentioned it at PT and she suggested orthopedic lift insets in the boot and at night a soft night splint at 90 degree angle. Willing to try anything.

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@janicemmccarthy

I have been to the knee surgeon, spine specialist and ankle specialist. No one has mention anything in the article. Ankle specialist boot me in a boot and said see you in 4 weeks. Night pain is so severe that I mentioned it at PT and she suggested orthopedic lift insets in the boot and at night a soft night splint at 90 degree angle. Willing to try anything.

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Hello @janicemmccarthy. I'm sorry to read that you are having unexplained pain in your ankle since knee surgery in 2020. Rehabbing from knee replacement surgery is more than enough to focus on, without added grief.

I live with a chronic pain syndrome called Central Sensitization Syndrome (CSS). Are you familiar with it? It brings to light a whole other thought process, that is, once specific problems are ruled out, and consistent pain is non responding to treatments.

It's an upregulation of the central nervous system and can happen unexplainably, or after a traumatic life event, or even after surgery. You mentioned you were willing to try anything…it might be worth checking out. What do you think?

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@janicemmccarthy

I have been to the knee surgeon, spine specialist and ankle specialist. No one has mention anything in the article. Ankle specialist boot me in a boot and said see you in 4 weeks. Night pain is so severe that I mentioned it at PT and she suggested orthopedic lift insets in the boot and at night a soft night splint at 90 degree angle. Willing to try anything.

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@janicemmccarthy In case you are curious…here is a video presentation on Central Sensitization Syndrome, given by Mayo Clinic's Dr. Sletten. Maybe something will click for you.
https://www.youtube.com/watch?v=8defN4iIbho

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@rwinney

@janicemmccarthy In case you are curious…here is a video presentation on Central Sensitization Syndrome, given by Mayo Clinic's Dr. Sletten. Maybe something will click for you.
https://www.youtube.com/watch?v=8defN4iIbho

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thank you, I will watch the video

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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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