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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@heyjoe415

I had TKRs on both knees this year. The surgeon used the Mako robotic assistant.

The first surgery in March was fine. Swelling came down, motion came back, and it felt like I was fully recovered in six weeks. Second surgery was in July. Motion came back but slight swelling has been stubborn. Pain in both knees is gone.

But the skin around my knees and part way down my shin is numb, or at least somewhat numb. Surgeon said that is normal and feeling may come back, may not.

So while this is nowhere near the problem you are having, like you, I wasn't warned in advance of this. It seems like some type of nerve damage, and personally, I don't hold out a lot of hope that this will change.

But I do hope your foot gets better. Not being able to touch your foot or put on a sandal is ridiculous, especially if you weren't warned that this is a possible side effect.

All the best to you. Joe

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Thanks Joe - I’m still experiencing foot neuropathy and knee pain . I’m taking 1800mg gabapentin which is working with minimal side effects. I’m still holding out hope that time will heal some if not all of the pain. I find I’m more prone to tripping these days and worry about my stability as I get older. However, on the bright side😊 I can pretty much do the things I love outdoors and I hardly have a scar on my knee to show for it.

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@didlick

I’m 16 mths post tkr & do hv neuropathy mainly in the Tkr foot. It includes toe pain, extreme irritation under big toe joint (in both feet) for which I use a cold pad that helps. I also use CBD oil for sleep & hv CBD salve that I massage into my foot & it also helps the arthritis in both hands.

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CBD has been a big help for me too

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@sueinmn

I'm sorry you have been suffering with pain after your knee replacement. Even the most meticulous surgery can cause unanticipated changes in our body mechanics. Like you, I found most surgeons to be uninterested in addressing the issue. Once the wound is healed and the implant is solid, quite a few feel their job is done - even when the patient is still suffering. Unfortunately that is because the surgeon is paid by insurance to operate. Some go the extra step, others are constrained by their practice policies or insurance companies, we just never know the "back story."

Also, there are many kinds and skill levels of physical therapists and therapy centers. Many seem to be "cookie cutter" clinics - with the minimum required number of actual certified therapists, and the remainder are physical therapy assistants, who simply supervise a set list of exercises that is their protocol for for each surgery or injury. Again, this may be due to how they are paid, and the rules governing numbers of sessions, etc.

Your idea of visiting a rehab specialist sounds just right to me. My best experiences were with a rehabilitation therapist associated with a center that handled complex cases - limb loss, traumatic injury, multiple surgeries, etc.

This was done on referral from my ortho doc, and covered by insurance due to "failed traditional therapy." It involved an extensive evaluation of alignment, gait, strength, flexibility and my goals. Then a custom program was set up including land and water therapy and extensive at-home exercise routine. It took many months, but the hip, back, neck & leg pain from my badly misaligned body was finally controlled.

May I suggest that you approach your surgeon with this request, and if they turn you down, ask your primary provider? People can share their stories and experiences on Mayo Connect, but at the end of the day you need to become your own best advocate.

Can you locate a rehab center or practice near you?
Sue

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Hi Sue
Thank you for your additional comments, which I have made notes of. I have spent time researching on the computer and can not find a rehabilitation doctor or therapist so far. I will keep trying and my next step will be to ask for referrals from both the current Orthopedic surgeon treating my left knee and also the rheoumatologist whom seems to be very knowledgable and has a lot of connections.
Thanks again

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@phigg

Thanks Joe - I’m still experiencing foot neuropathy and knee pain . I’m taking 1800mg gabapentin which is working with minimal side effects. I’m still holding out hope that time will heal some if not all of the pain. I find I’m more prone to tripping these days and worry about my stability as I get older. However, on the bright side😊 I can pretty much do the things I love outdoors and I hardly have a scar on my knee to show for it.

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You have a great attitude considering what you're going through, and that will get you far. I do hope that the neuropathy and pain in your foot resolves with time. It's tricky dealing with nerves. I've had two bouts of sciatica. One resolved on its own, the other required only minor surgery. Both were over 10 years ago.

Stay strong and enjoy nature. That way, you win no mater what the outcome.

Joe

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I had left TKR 9 months ago. Recovery was going fine until 12 weeks when that knee developed numbness which makes the knee feel weak when walking and impairs my walking. My Ortho said it is caused by my back and not knee surgery. However, I have read in reputable sources that up to 10% of TKR can result in nerve damage. I do have spinal stenosis as well. An upcoming EMG will hopefully shed light on the source of the nerve involvement but the timing of this numbness seems a bit too coincidental to the knee surgery. I have no other knee pain and full flexion and extension. I, too, was not warned of this or any other possible complications. I certainly will ask more questions with any further surgeries.

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@westcom

I had left TKR 9 months ago. Recovery was going fine until 12 weeks when that knee developed numbness which makes the knee feel weak when walking and impairs my walking. My Ortho said it is caused by my back and not knee surgery. However, I have read in reputable sources that up to 10% of TKR can result in nerve damage. I do have spinal stenosis as well. An upcoming EMG will hopefully shed light on the source of the nerve involvement but the timing of this numbness seems a bit too coincidental to the knee surgery. I have no other knee pain and full flexion and extension. I, too, was not warned of this or any other possible complications. I certainly will ask more questions with any further surgeries.

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EMG didn’t do much for me but guess that’s a good thing.
Good luck, it’s frustrating not to know what all the TKR
HAS CAUSED BUT I do know that I’ve had many things after that I NEVER EXPERIENCED prior.

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I’m into it now almost two years after TKR. Went to a different surgeon, not a TKR surgeon, and he said yes, could be caused by the TKR. Wants me to give it time but it’s never changed, almost 100% of the foot neuropathy comes in the early evening so I take 600mgs of gabapetin to help me sleep through it. That works right now.
I personally have also seen a deep vein tissue surgeon, two neurologists and a foot specialist and they all basically say the same thing, “can’t find the cause of it”.
Disgusted here.
Vince

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I had the same thing happen to be hours after surgery my foot had lot’s of pain 14 months later and I am still in pain. And it turns out I need another knee replacement because I have a recall yes a recall

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@grandmazoo711

I had the same thing happen to be hours after surgery my foot had lot’s of pain 14 months later and I am still in pain. And it turns out I need another knee replacement because I have a recall yes a recall

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A recall? Who was the manufacturer of your prosthesis?

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I am day 2 TKR. The numbness and pain in my foot is unbearable. I am able to flex my foot and wriggle my toes but it honestly feels like someone stuck my foot in a ice block then hit it with a sledge hammer. I have been doing my daily at home PT and the pain at incision site is fine it is just this numbness and foot pain. The doctor said the pain could be due to manipulating the tibia and the numbness is possible caused by stretching the nerve but pain medicine doesn’t even alleviate the pain I feel is this foot. Has anyone experience this before?

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