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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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fourj | @fourj | Sep 17, 2023
In reply to @bitfiddler "Hah, I guess we sometimes see what we want and not what it really is. At..." + (show)
@bitfiddler

Hah, I guess we sometimes see what we want and not what it really is. At least I learned about a specialty I hadn't before, thanks.

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It's the first I've heard of a physiatrist as well.

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sma2day | @sma2day | Sep 17, 2023
In reply to @eve38 "Yes, I saw a Physiatrist over the Summer! I had never heard of one before, but..." + (show)
@eve38

Yes, I saw a Physiatrist over the Summer! I had never heard of one before, but my hand OT therapist recommended it, and facilitated my getting an appointment set up. I was very pleased with my experience, he addressed both my hands and my feet, which has not been done before because of how compartmentalized the different specialties are. He prescribed a cream that was made at the compounding pharmacy, which is proving to be of real value to me. Unfortunately it is not paid for by my insurance, but since it spreads so well I do not need to use very much for excellent effects. I have small fiber neuropathy, Raynaud's, metatarsalgia and tendon inflammtion, so a variety of issues. I use the cream in the evenings and am finding that I sleep much better as my feet are calmed! A wonderful relief not to be tossing and turning because I cannot get my feet comfortable on the mattress, and because of the nerve buzzing. He also tried a deep heat laser treatment, but it turned out to be more than my feet could tolerate, so we discontinued those treatments.

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Hello can you please tell me the name of the cream as my husband could really use it. We are looking into a psyiatrist also! Hope you feel better!

Thanks
Sheila:)

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1 reply
eve38 | @eve38 | Sep 17, 2023
In reply to @sma2day "Hello can you please tell me the name of the cream as my husband could really..." + (show)
@sma2day

Hello can you please tell me the name of the cream as my husband could really use it. We are looking into a psyiatrist also! Hope you feel better!

Thanks
Sheila:)

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It doesn't have a name as the Physiatrist had the compounding pharmacy make it up special for my situation, which is something they can do! It has Gabapentin, a strong ibuprofin, a muscle relaxant, and Lidocaine. I got some over the counter lidocaine cream from the drug store, to see if the doctor's cream was just numbing the pain, but the plain lidocaine ointment did nothing for me, so must be the other ingredients. I hope your husband finds some help and relief. My physiatrist told me he has other combinations too if this cream stops working so well, but right now it is great. I really can't believe how much it helps me sleep at night because my feet are calm...

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1 reply
julbpat | @julbpat | Sep 18, 2023
In reply to @eve38 "Yes, I saw a Physiatrist over the Summer! I had never heard of one before, but..." + (show)
@eve38

Yes, I saw a Physiatrist over the Summer! I had never heard of one before, but my hand OT therapist recommended it, and facilitated my getting an appointment set up. I was very pleased with my experience, he addressed both my hands and my feet, which has not been done before because of how compartmentalized the different specialties are. He prescribed a cream that was made at the compounding pharmacy, which is proving to be of real value to me. Unfortunately it is not paid for by my insurance, but since it spreads so well I do not need to use very much for excellent effects. I have small fiber neuropathy, Raynaud's, metatarsalgia and tendon inflammtion, so a variety of issues. I use the cream in the evenings and am finding that I sleep much better as my feet are calmed! A wonderful relief not to be tossing and turning because I cannot get my feet comfortable on the mattress, and because of the nerve buzzing. He also tried a deep heat laser treatment, but it turned out to be more than my feet could tolerate, so we discontinued those treatments.

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This sounds great. I too have the compounded cream. I think I read about it here, and asked my neurologist to prescribe it for me.
My health care is good, but very scattered. I’m inspired now to look for a physiatrist!

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2 replies
eve38 | @eve38 | Sep 18, 2023
In reply to @julbpat "This sounds great. I too have the compounded cream. I think I read about it here,..." + (show)
@julbpat

This sounds great. I too have the compounded cream. I think I read about it here, and asked my neurologist to prescribe it for me.
My health care is good, but very scattered. I’m inspired now to look for a physiatrist!

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Scattered is a very good way to describe health care these days! I have actually gotten more tangible, and effective care through the Orthopedic route, that has led to PT/OT and the Physiatrist, then I have from any other specialty. Unless I want to take Gabapentin orally, the Neurologist has told me they have nothing to offer me. I much prefer using it topically, and it works!

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fourj | @fourj | Sep 18, 2023
In reply to @julbpat "This sounds great. I too have the compounded cream. I think I read about it here,..." + (show)
@julbpat

This sounds great. I too have the compounded cream. I think I read about it here, and asked my neurologist to prescribe it for me.
My health care is good, but very scattered. I’m inspired now to look for a physiatrist!

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We're all looking for the answer for a cure or some sort of relief from the pain. When one doctor doesn't have the answer we go looking elsewhere in desperation, thus our Healthcare becomes scattered. I believe we are piecing our pain relief together by means of whatever helps us individually. We all know that we'll try anything.

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julbpat | @julbpat | Sep 18, 2023
In reply to @eve38 "It doesn't have a name as the Physiatrist had the compounding pharmacy make it up special..." + (show)
@eve38

It doesn't have a name as the Physiatrist had the compounding pharmacy make it up special for my situation, which is something they can do! It has Gabapentin, a strong ibuprofin, a muscle relaxant, and Lidocaine. I got some over the counter lidocaine cream from the drug store, to see if the doctor's cream was just numbing the pain, but the plain lidocaine ointment did nothing for me, so must be the other ingredients. I hope your husband finds some help and relief. My physiatrist told me he has other combinations too if this cream stops working so well, but right now it is great. I really can't believe how much it helps me sleep at night because my feet are calm...

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I have had two different recipes of the pain cream, with different ingredients, but all with the same intent. If your doctor isn’t familiar with it, just ask the pharmacist at a compounding pharmacy for the list of ingredients. You can share that info with the doctor, and they should be happy to order it. Look for a local “compounding” pharmacy, not a chain outlet.

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Ray Kemble | @ray666 | Sep 18, 2023

Good morning, all!

Perhaps I should clarify. It seems I was the first to reply to the member's post and said I'm seeing a neurologist who identifies himself as a physiatrist. I never meant to suggest by my reply that my neurologist/physiatrist is offering until-now unprescribed medications or atypical therapies (although I did wonder what might be in store for me when I went to my first visit). What sets my neurologist/physiatrist apart – and why I value his help so much – is his interest in my other ailments – other than my PN – and the lengths to which he goes to consider the WHOLE me when discussing my PN. I regard that as almost unique, and why I'm glad to be in the care of a neurologist who also fancies himself a physiatrist.

Cheers!
Ray (@ray666)

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Moderator
Amanda Roe | @amandajro | Sep 18, 2023
In reply to @fourj "Has anyone seen a physiatrist for their neuropathy? Had TKR 10 months ago. Ended up with..." + (show)
@fourj

<p>Has anyone seen a physiatrist for their neuropathy? Had TKR 10 months ago. Ended up with numbness and pain on heel and lateral sole of foot. Now going to see a physiatrist.</p>

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Hello @fourj. You will see that I have moved your post and the responses into an existing discussion on this topic, which I believe you have been already active in. You can find your post here now:
- Foot neuropathy (numbness and pain) after total knee replacement (TKR): https://connect.mayoclinic.org/discussion/foot-neuropathy-after-total-knee-replacement/

I see several members such as @ray666 @bitfiddler @pacer3702 and @eve38 have all joined you to share their experiences.

When is your appointment scheduled for?

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3 replies
fourj | @fourj | Sep 18, 2023
In reply to @amandajro "Hello @fourj. You will see that I have moved your post and the responses into an..." + (show)
@amandajro

Hello @fourj. You will see that I have moved your post and the responses into an existing discussion on this topic, which I believe you have been already active in. You can find your post here now:
- Foot neuropathy (numbness and pain) after total knee replacement (TKR): https://connect.mayoclinic.org/discussion/foot-neuropathy-after-total-knee-replacement/

I see several members such as @ray666 @bitfiddler @pacer3702 and @eve38 have all joined you to share their experiences.

When is your appointment scheduled for?

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Ultrasound of foot and ankle - October 10, 2023
Physiatrist - October 13, 2023

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