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Old 08-12-2009, 07:06 PM   #1
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Severe nerve pain post surgery

I recently had surgery on July 29th to repair a torn ligament in my foot and re-attach the "flap" that goes over the ankle.

The surgeon said the surgery went well and to expect 5 weeks of a hard cast with no weight bearing for the first 2.

The first week went fine, reasonable pain but tolerable. Around the week 2 mark, I started getting awful nerve pain across the top of my foot. The pain is unbelieveable and no one seems to know what's causing it. The doc seems to think the cast was too tight and it was compressing on the nerves when it swelled up; so he took off the original one and put on a new one that isn't as tight. This isn't working either.

In addition, the skin on the top of my foot is VERY sensitive to touch and looks like its "sun burned".

Has anoyone experienced this before? The pain is so bad and I don't know what to do. As luck would have it, neither does my doctor! I'm looking for the cause as well as treatment.

Thanks!!

 
Old 08-12-2009, 08:23 PM   #2
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Re: Severe nerve pain post surgery

I was in a CAM boot and developed a red painful area on top of the foot - about 3" down from the big toe, where that little bump is. I experienced numbness in my second toe and on the bottom of my foot along my toes. This was 6 weeks ago and I've been out of the boot 2 weeks. It's still sore to the touch. The bottom numbness is gone but my toe is still numb. I'm thinking it will take time to get back to normal. Not sure if this is similar to what you are experiencing. I added padding to that area while in the boot and it didn't get worse, but it didn't get better either.

 
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Old 08-13-2009, 07:10 AM   #3
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Re: Severe nerve pain post surgery

That sounds similiar to what I have except I don't have any bumps and its more of a "dark sun tanned color" - the feeling however is what you described. It also covers the whole top of my foot. The doctor says the pain is caused by the nerves in my foot; which are very inflammed. However he doesn't know know what's causing it. So frusturating as its VERY painful.

Thanks for the info.

 
Old 08-13-2009, 02:01 PM   #4
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Re: Severe nerve pain post surgery

I had surgery 18 months ago and started out with the entire top of my foot numb. As the feeling started returning I remember that my pinkie toe felt like it had a severe sunburn for a few days. That went away and turned into itchiness. It took about 9 months but I finally got about 90% of the feeling back. I still have burning sensations and itchiness but it's pretty minor. I remember that pain medication really helped take the hot burning pain away. you might try that. I used to love having my feet rubbed but post surgery my nerves are just too sensitive anymore. Bummer! My foot also turned incredible shades of purple, red for about 6 months. I think what you're experiencing is not uncommon. My OS said he was sure he didn't injure any nerves. I think the tourniquets that they use during surgery can cause nerve damage but just my theory .....

Hang in there - I think it will soon get much better!

Abby

 
Old 08-13-2009, 09:31 PM   #5
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Re: Severe nerve pain post surgery

Kelly, was the surgery arthroscopic or an incision? After my PTTD surgery I had nerve pain similar to what the other posters are describing. It was caused by irritation to the sural nerve during the surgery. It affected the top and lateral side of my foot and included the little toe and the one next to it. that lasted about a year then resolved itself (not completely but about 75% better).

After my arthroscopy (2 years later) I had severe nerve pain which went from the front of my ankle across the top of my foot toward the big toe. The area between my big toe and second toe is extremely sensitive to touch and is numb. This type of nerve pain is caused by the deep peroneal nerve. It can be irritated during arthroscopy because of it's location. Unfortunately it is at risk for damage because it is in the area where they manipulate the instrument. I wouldn't be too concerned unless it continues to cause pain with little or no improvement. Your surgeon can refer you to a neuro for a Nerve Conduction Study/EMG which will tell you if there is nerve involvement. The good news is that the nerves can just heal themselves, according to the neuro I saw. It hasn't happened to me yet but I haven't given up hope that it will.

In the meantime they can put you on a nerve medication which may give you some relief. Regular narcotics are not always effective for nerve pain. But there is Neurontin, Lyrica and some anti-seizure meds that can be very effective. I have tried several different ones and am currently on Cymbalta which has worked the best for me. My EMG showed the deep peroneal nerve not conducting anything and some reduced conduction in the sural nerve. You may want to consider asking for this test if your pain continues. It is a quick test and not painful and the neuro told me my results as he was doing the test.

Best of luck to you.

emmie

 
Old 08-14-2009, 06:55 AM   #6
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Re: Severe nerve pain post surgery

Thanks for the feedback.

I had an actual incision for the surgery, it wasn't orthoscopic. The doctor claims he didn't even have to cut through any nerves for the surgery beacuse of where they went in which doesn't make sense with all of the nerve pain.

I went back to see him yesterday and he thinks I have RSD (Reflex Sympathetic Dystrophy) I did some research last night and all of my symptoms were listed. Has anyone ever heard of it ?

 
Old 08-15-2009, 04:04 AM   #7
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Re: Severe nerve pain post surgery

I'm joining this thread late as I was away from a computer. I had terrible nerve pain following the suture removal. This was two weeks after surgery and I still had temporary pins. I walked too much and was ordered nwb for a week. It was during this time I found this board in a desperate search for answers.
My doctor didn't seem to know why I was experiencing the nerve pain either. I was in agony. The pain was excruciating. I can sympathize. I never felt anything like it except when I had dental work without anesthesia. Same intense nerve pain. I had incisions on either side of my foot with osteotomies, so our surgeries were different. After the week off my foot, the pain went away. I hope you find relief soon.

 
Old 08-15-2009, 07:55 AM   #8
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Re: Severe nerve pain post surgery

Well, we've had a recent development.. my doctor thinks I have RSD (Relex sympathetic dystrophy). I've done a lot of research on it and all of my symptoms match. I'm going to start injections next week which will hopefully reverse it. I guess we'll see. Thanks again.

 
Old 08-15-2009, 01:55 PM   #9
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Re: Severe nerve pain post surgery

I'm sorry. Are there tests that can confirm the diagnosis? What type of injections will you receive?

 
Old 08-15-2009, 03:27 PM   #10
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Re: Severe nerve pain post surgery

No, they're aren't any tests that can be performed but since we have tried everything else, I believe he is right. All of the symptoms match what I have. He's going to inject the nerves with a steroid to try and calm them down. He feels this might reverse the RSD. I hope so.

 
Old 08-16-2009, 03:59 AM   #11
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Re: Severe nerve pain post surgery

Good luck! Hope you find relief soon.

 
Old 08-16-2009, 06:00 PM   #12
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Re: Severe nerve pain post surgery

Kelley0514,
RSD is a awful thing to have.I got it from a bone chip surgery in 2008 as my doc didn't numb the foot properly. I have it and please make sure if the injection is in your back you go somewhere that does the injection while they are watching where the needle is inserted. I believe it is called a florascope.Do not let your clinic do it. I didn't know better and had it done at my clinic and she hit my spinal cord which pretty much gives you the worst headache in the world. I ended up in the hospital for 8 days a trillion tests, lots of morphine before they drew my own blood (called a blood patch) and injected it into my back to stop the leak.
i have flares every now and then and there is medication that helps. There is remission but know one can tell you for how long. I am not trying to scare you but help you be more informed. The RSD coalition is a good place to get advice as only persons with the disease are aloud on their website. Please ask me anything you need, I'll do my best to help you.
Wa11eye

 
Old 08-16-2009, 06:18 PM   #13
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Re: Severe nerve pain post surgery

Thank you for the info. I'm sorry to hear that you have gone through a similar problem. My biggest problem right now is trying to find a specialist. My Podiatrist is currently treating me and I would like to see someone who has experience with this issue. Do you have any suggestions on how to find someone? I've called several pain mgmt clinics and neurologists but they didn't have exp with RSD. My doc wants to do the steroid injections on Thurs and I was advised that injections directly into the foot could cause it to spread. I desperatley want relief but don't want to risk the spead either; who do I believe, ya know? I'm just getting a lot of conflicting info and don't know what direction to go into.

 
Old 08-17-2009, 05:20 PM   #14
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Re: Severe nerve pain post surgery

Please goggle RSD coalition in your state. Join and they can help you find a clinic and doc in your area. I have never heard of an injection into the area. And YES it can cause spread or worse pain. There are medications such as lyrica, gabapentin (neourtin) Not sure on the spelling, Topomax and others. I would try one of those before I'd let them stick you. You could see relief in a couple of days and this would give you time to locate a doctor. I feel for you as I have been exactly where you are now. Scarred senseless!!!!! Horrified with not getting any relief. Not knowing what or where to go. I took alot of drugs to dull the burning pain and spent a day in the er getting morphine to help control it. I'll try to see if I can locate some help for you.

 
Old 08-17-2009, 05:39 PM   #15
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Re: Severe nerve pain post surgery

My Dad contacted a RSD support group in Chicago and got in contact with the leader who referred me to her specialist in Chicago. With her referral, I was able to get an appointment on Wednesday! This way I can speak with them before getting any injections. I agree with you, I think its best to talk with someone who has exp before moving fwd with anything. I'll let you know how it goes on Wednesday.

Last edited by moderator2; 08-29-2009 at 05:17 PM.

 
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