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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@tamstur

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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Wonder if the block is taking a long time to wear off. Years ago when I had torn meniscus surgery with a block it took over 48 hours to wear off, my whole leg was rubber couldn’t weight bear at all

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@tamstur

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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Have you ca lo your surgeon to ask about it. Maybe a lot of swelling around nerves? Worth a call to your md

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@tamstur

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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Welcome @tamstur. I'm sorry to hear that you're dealing with numbness and pain in your foot after a successful knee replacement. I've moved your question to this existing discussion called:
- Foot neuropathy (numbness and pain) after total knee replacement (TKR) https://connect.mayoclinic.org/discussion/foot-neuropathy-after-total-knee-replacement/

I did this so you can read past posts from members going through something similar and helpful tips from others. I agree with the suggestions that @dmk made.

Tamstur, you're on day 3 or 4 now. Has the pain and numbness lessened?

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@colleenyoung

Welcome @tamstur. I'm sorry to hear that you're dealing with numbness and pain in your foot after a successful knee replacement. I've moved your question to this existing discussion called:
- Foot neuropathy (numbness and pain) after total knee replacement (TKR) https://connect.mayoclinic.org/discussion/foot-neuropathy-after-total-knee-replacement/

I did this so you can read past posts from members going through something similar and helpful tips from others. I agree with the suggestions that @dmk made.

Tamstur, you're on day 3 or 4 now. Has the pain and numbness lessened?

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The foot numbness is still present but the pain has changed to a feeling of fire in my toes. Which could be nerve regeneration I am suspecting. The nerve block that was applied has worn off and the numbness has moved from my entire foot to the middle of sole to toes top and bottom. Nighttime is worse.

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Yes I had bad neuropathy in my left foot after TKR, mine developed about 6months after surgery and last about a year. I found great relief using a 1:1 CBD to TCH lotion. I would coat the bottom of my foot at bedtime, I wore a sock on that foot and I would be pain free for 3-4 days , then I would have to re-apply. I did this for about a year then started noticing less and less pain in foot , until I realized it was gone. It is now almost 4yrs since TKR and foot pain never came back. The pain in my leg just below knee is a whole different story. I spend every day trying to walk with pain in the 8-9 range. But I keep searching for answers, best of luck, LOOK INTO THE CBD:THC CREAM IT WORKED FOR ME

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@dmk

Have you ca lo your surgeon to ask about it. Maybe a lot of swelling around nerves? Worth a call to your md

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I did reach out but got the on call doctor so I am waiting until tomorrow after holiday to call their office because I definitely need something better at night to control the pain. The pain in my foot feels like my toes are on fire at times which could be due to nerve regeneration as I have read. The numbness is still very present and feels like I am walking on large chunks of pebbles. Weirdest and worse pain ever. Not to much pain in leg some achy around knee. Swelling is still present as ever and my leg feels like a ballon. The calf is better but still very tight as well as quad.

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@sprinrosa64

Yes I had bad neuropathy in my left foot after TKR, mine developed about 6months after surgery and last about a year. I found great relief using a 1:1 CBD to TCH lotion. I would coat the bottom of my foot at bedtime, I wore a sock on that foot and I would be pain free for 3-4 days , then I would have to re-apply. I did this for about a year then started noticing less and less pain in foot , until I realized it was gone. It is now almost 4yrs since TKR and foot pain never came back. The pain in my leg just below knee is a whole different story. I spend every day trying to walk with pain in the 8-9 range. But I keep searching for answers, best of luck, LOOK INTO THE CBD:THC CREAM IT WORKED FOR ME

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Oh goodness. I will look into creams I’m hoping this resolves on its own seeing I am only day 4 post op. I will definitely keep you in my thoughts and prayers arhat your pain does resolve or you get an answer. What kind of knee did they give you? Mine is titanium and they did use cement. I wonder if you have scar tissue built up causing your pain.

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@tamstur

I did reach out but got the on call doctor so I am waiting until tomorrow after holiday to call their office because I definitely need something better at night to control the pain. The pain in my foot feels like my toes are on fire at times which could be due to nerve regeneration as I have read. The numbness is still very present and feels like I am walking on large chunks of pebbles. Weirdest and worse pain ever. Not to much pain in leg some achy around knee. Swelling is still present as ever and my leg feels like a ballon. The calf is better but still very tight as well as quad.

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I know for both my RTS and TKR one of my routine meds was high dose anti inflammatory and aspirin. I’m just not sure that pain meds will work. Also used cryotherapy (ice machine), a special bolster for my leg, and therapist did dry needling before surgery which helps relax tight muscles but it’s too soon for that post op for you. I know it was close to 4 months before I was able to get some sleep. My pt also had me at his clinic the day I got home from hospital. Also 2 months in I started water aerobics.
Nerve pain as you describe is no fun. Hope between your surgeon and your therapist can help.
My heart goes out to you!

On Sep 5, 2022, at 10:15 AM, Mayo Clinic Connect wrote:



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@tamstur

I did reach out but got the on call doctor so I am waiting until tomorrow after holiday to call their office because I definitely need something better at night to control the pain. The pain in my foot feels like my toes are on fire at times which could be due to nerve regeneration as I have read. The numbness is still very present and feels like I am walking on large chunks of pebbles. Weirdest and worse pain ever. Not to much pain in leg some achy around knee. Swelling is still present as ever and my leg feels like a ballon. The calf is better but still very tight as well as quad.

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I had a numb leg from knee down and totally numb foot. like you said rubber when you stand up and feels like walking on gravel. Foot was cold and toes turned purple. Surgeon said it was normal - nerve damage. long story short...the surgeon pinched the popliteal artery behind my knee during surgery which cut off all blood supply to my lower leg and foot. 6 weeks later my primary said NOT NORMAL. did an ABI test (blood pressure test of legs) and then angiogram that found the pinched artery. Had to have yet another surgery where that surgeon took out a dead dried blood clot and opened the artery so I now have blood flow again, but since it was almost 2 months no blood to foot I have permanent tissue and cell damage and numbness to toes and other parts of foot. My knee dr.,when I told him what he did just said..."Why did you wait so long to get it fixed...you could have lost your leg" REALLY
Don't give up keep looking for answers! I did have a spinal injection to see if that would help and it did for about a year, but never go rid of all the issues. That Dr. just told me your knee dr. damaged more that the popliteal artery. It has been 3 1/2 years now. no change.

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@vinran

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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Vince, ask for an ABI test (blood pressure test of legs) and if there is less pressure in that leg, then ask for an angiogram. That is how they found my problem with a totally numb foot after my tkr. My surgeon pinched the popliteal artery behind my knee during surgery but kept telling me it was normal. (the artery that supplies the blood to lower leg/toes) My numbness was not normal. I had yet another surgery by a different surgeon who opened up the artery and took out a dead blood clot then patched the artery and sewed it up. 12 inch scar on back of leg by knee. My TKR surgeon just told me after I told him what he did was "Why did you wait so long to get it fixed...you could have lost your leg"
I went to several other ortho drs. walk in. nerve tests. they looked for clots in my veins (but not the artery). took my primary to find the problem.
Well I have my leg and foot, but have permanent damage to cells and tissue in foot and 3 toes are numb yet since it was 2 months between surgeries.
Good luck! I feel your pain! Lori

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