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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@crazz

In the same position, with Right TKA which is doing well, but had severe pain in right foot for 4 months and has turned to more numbness and tingling at the 5 months today. Lyrica 75mg 4 x a day in the beginning and now down to once a day has been a life savor for me. Im pretty certain I would not have gotten to full extension, flexion in my knee without it! The foot pain was effecting my knee PT in the beginning. I also used 50mg Tramadol as needed, more in the beginning and now 1 x day. I was very nervous it would not improve or never go away, but I have seen a great improvement in the last couple of weeks. Unfortunately i cant exercise much or the foot gets really aggravated, i do go to a therapy pool 5-6 days a week which I really think helps a lot. Im 55 and exercised daily prior to surgery and had no underlying conditions other than arthritis. Im considering exercising more and just increasing the Tramadol as I believe the more active I am the sooner the nerve will heal??? Would appreciate input from others on this. You are lucky your doctor acknowledged the pain/tingling as mine said he had never heard of such a thing?

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It took my primary to say lets do more testing. My TKA surgeon just told me give it a year or two. I thank God for my primary every day and the surgeon who did the surgery on the popliteal artery that my TKA pinched off.

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Hi @norby… I had a TKR January 14 2019 and woke up with the bottom of my foot numb…. Honestly the pain was so unbearable stinging burning pain… My surgeon put me on Lyrica… The 2nd week in April I could feel the bottom of my heel and now today I can move my toes but it still numb below my toes though…. But my surgeon did say sometimes the nerve can get stretch…. I will keep you in my prayers.

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I hear foot neuropathy also, The numbness tingling in my foot came right after surgery. However then about two weeks later I got sciatica, which is totally worse than the knee pain. I am in physical therapy for it and I am also going to pain Management for Cortizone shots in the sciatica. Everyone I talk to including my doctor blames it on something else so now I don’t know what’s going to happen I just hope I can get rid of the neuropathy and the sciatica. Very frustrated

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@loriaakre

It took my primary to say lets do more testing. My TKA surgeon just told me give it a year or two. I thank God for my primary every day and the surgeon who did the surgery on the popliteal artery that my TKA pinched off.

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Lori, now that you know what it is what are you doing for it? I just need to know which way to go with this. My foot was totally numb right after surgery which was May 21st, two weeks later I started pain And what everybody now was telling me my sciatica, however I have the foot neuropathy before the sciatica ever started acting up right now I feel I’m in limbo

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It’s been 2 1/2 yrs of pain and numbness of my foot since my total knee surgery. Ortho chose to deny that it was anything to do with the procedure. Still happening and is causing continual problems. Waiting and praying that someone can help me. I walk with a cane because I don’t know where I am placing my foot sometimes and fall. Not recommended when both knees have been replaced! The pain is hard to describe, sometimes dull and aching, other time sharp and stabbing, other times it feels like someone is putting straight pins under my toenails. The numbness is strange as it is in different places on my foot. I still have pain in my and severe swelling below it. Help

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@cindymac

It’s been 2 1/2 yrs of pain and numbness of my foot since my total knee surgery. Ortho chose to deny that it was anything to do with the procedure. Still happening and is causing continual problems. Waiting and praying that someone can help me. I walk with a cane because I don’t know where I am placing my foot sometimes and fall. Not recommended when both knees have been replaced! The pain is hard to describe, sometimes dull and aching, other time sharp and stabbing, other times it feels like someone is putting straight pins under my toenails. The numbness is strange as it is in different places on my foot. I still have pain in my and severe swelling below it. Help

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So sorry to hear you have been suffering for over 2 years. My foot as well was numb and tingling after my right TKR. I keep going to different doctors until I found someone who cared and she ordered an ABI Test. It measures the pressure in your legs. When they found the pressure was .4 on my right and 1.26 on my left, I was sent to a cardiologist who ordered an angiogram which showed the popliteal artery behind by knee was totally blocked. The knee surgeon had pinched it during my TKR. I had yet another dangerous surgery where a vascular surgeon cut open the back of my knee and opened the artery. I got 1/2 the numbness and tingling gone right away and my toes were not purple and my foot was not cold. If I would of listened to my knee surgeon who kept saying give it a year or too, I would of lost my leg from my knee down. As it is I probably have cell and tissue damage to my foot from not having any blood flow for 60 days. I may or may not get full feeling back. I am taking gabapentin for the pain in my foot.
The ABI test is a simple test done by ultrasound. I wish you the best!

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Hi there, I have the same problem as you. I had my knee surgery on Aug 27 only a month ago but I still have numbness in my foot. It is so uncomfortable, I know how you're feeling. They say it would take weeks to months to go away. I certainly hope it goes away.

Take care.

Josie

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So sorry you have the numbness in the foot. Yes it is very uncomfortable. My Surgeon told me 1 to 2 years as nerves only heal 1 mm a day and it is a long way to your feet. Have them do an ABI test. It measures the pressure in your legs. It's just like a blood pressure test. that is how they determined that I had a blocked popliteal artery behind my knee that supplies blood flow to my foot and needed surgery to open it up. My toes were purple and foot was cold all the time. Half of the numbness went away right after that surgery and my toes were not purple and foot was warm, but still has some numbness and my foot feels cold but really isn't. They did put me on gabapentin which did help some of the pain, but not all of it. It took a lot to convince a dr. that it wasn't normal. It was my primary that finally said it was not normal. It was 60 days out from TKR that I had the popliteal artery surgery. I had also told the surgeon that my knee clicks all the time from day one. of course that is normal as well. well now I found out 7 months out that I have a fractured knee cap. I have an appoint next week with the surgeon. Will be interesting to see what he has to say now. The surgeon will NOT take responsibility for what they do wrong! I saw 5 different dr. who all said it was normal. I had had my other knee done in 2013 so I knew what normal should of been.
Take care of YOU! and be an advocate for yourself.

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@loriaakre

So sorry you have the numbness in the foot. Yes it is very uncomfortable. My Surgeon told me 1 to 2 years as nerves only heal 1 mm a day and it is a long way to your feet. Have them do an ABI test. It measures the pressure in your legs. It's just like a blood pressure test. that is how they determined that I had a blocked popliteal artery behind my knee that supplies blood flow to my foot and needed surgery to open it up. My toes were purple and foot was cold all the time. Half of the numbness went away right after that surgery and my toes were not purple and foot was warm, but still has some numbness and my foot feels cold but really isn't. They did put me on gabapentin which did help some of the pain, but not all of it. It took a lot to convince a dr. that it wasn't normal. It was my primary that finally said it was not normal. It was 60 days out from TKR that I had the popliteal artery surgery. I had also told the surgeon that my knee clicks all the time from day one. of course that is normal as well. well now I found out 7 months out that I have a fractured knee cap. I have an appoint next week with the surgeon. Will be interesting to see what he has to say now. The surgeon will NOT take responsibility for what they do wrong! I saw 5 different dr. who all said it was normal. I had had my other knee done in 2013 so I knew what normal should of been.
Take care of YOU! and be an advocate for yourself.

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Thank you for the information. I really appreciate you sharing your story with me. I called my family dr and I asked if I could get the ultra sound done on my feet. Maybe I'll get some answers.

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good luck! the ABI is a test on your legs. You could also have a nerve test done by a neurologist. I was going to have one done but since I am on Plavix (a blood thinner) he would not do one.
Wishing you the best.

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@sandie2749

Lori, now that you know what it is what are you doing for it? I just need to know which way to go with this. My foot was totally numb right after surgery which was May 21st, two weeks later I started pain And what everybody now was telling me my sciatica, however I have the foot neuropathy before the sciatica ever started acting up right now I feel I’m in limbo

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I think I am replying to the post by sandie? I am 6 months out from right tkr and what you are experiencing sounds like what I did right after surgery. I have gone to a neurologist, podiatrist and back to my surgeon a few times trying to figure out if it is a nerve or tendon problem. My foot pain started getting much better as I increased movement on stationary bike -about 2 months after surgery. Then the sensations changed, less numbness and pain, but fatigue feeling in the foot followed by pain, as well as ankle, but the knee felt fine. Then it all became worse at 5 months, and although I just reached a mini goal of cycling 50 miles yesterday, when I have only been able to do only 20-30 since I got on my road bike in June, I have extreme pain when I have my knee bent and move my leg to the left. Pain goes from the back of my knee, down the leg to the inside of my foot, and my big toe is usually numb. I also have extremely tight pulling behind my right hip or lower back. When I do heel slides or go down deep stairs, it pulls incredibly painfully. Do you have this? My podiatrist and PT think there was too much pressure on one of my nerves (maybe peroneal) during surgery. The surgeon denies any connection and will not talk about it. I had a nerve velocity test done and the neurologist was very skeptical, reported no sensation in a nerve that is not associated sith any symptoms or possible problems. I think he misreported, he was very rude to me, like "you are crazy to think it has anything to do with tkr". I am trying to get my surgeon to approve of a repeat test with someone else. Do you have pain down your leg? They think it may be my sciatic nerve with the tightness problem in my right lower back…just can't figure it out.

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@loriaakre

good luck! the ABI is a test on your legs. You could also have a nerve test done by a neurologist. I was going to have one done but since I am on Plavix (a blood thinner) he would not do one.
Wishing you the best.

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Thanks for the info i'll mention it to my family doctor. Have a good night.

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