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.
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.
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.
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!
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.
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 ?
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.
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.
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.
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.
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.
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.
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.
No, they're aren't any tests that can be performed but since we have tried everything else, I believe he is right.
Nerve conduction studies can be a diagnostic tool for RSD. As well as angiograms and MRI's. Negative results doesn't rule out RSD but these tests can sometimes confirm it. Also, a nerve doesn't have to be cut to sustain damage. Simply moving it out of the way (which commonly occurs during foot surgery) can result in damage. And, the nerve can become entrapped in scar tissue. If it were me, I would ask for a referral to a neurologist and seek a second opinion before I would just accept an RSD diagnosis. It may well be RSD but I would exhaust all testing first. Just my opinion! They suspected RSD with me, too, but there were some definite RSD symptoms that I didn't have and since my nerve conduction was positive they are leaning toward entrapment or damage.
Best of luck to you. I know this is an upsetting experience. I hope you get some answers and respond well to the treatment.
I totally agree with the advice of a 2nd opinion. I was referred to a RSD specialist and I'm going to see him tomorrow. I assume he will send me for an MRI or other test to see if it is in fact RSD. Either way, I hope to get some piece of mind and am hopeful that he will provide it since he has a lot of exp dealing with these types of patients.
oh, good, Kelly. I'm glad you are being proactive. From what I've heard and read, the sooner you can jump on treatment the better the chance of arresting it. Just curious...what kind of doctor is an RSD specialist? Is it a neurologist? I would be interested in hearing what they do for you.
I really hope you get answers soon. I'll be sending good thoughts your way.
I am glad to hear you found someone. Let us know what you find out. Neurolgists are not always the best. I went to one who boasted about treating rsd only to find out she didn't what a waste of my time and money. Ask lots of questions surf the web anything to help with answers.
Last edited by moderator2; 08-29-2009 at 05:17 PM.
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I saw a doctor at a Pain Mgmt Clinic - he specializes in RSD ad has a lot of exp with it. I was referred to him by my support group leader who has been seeing him for 20+ years. He is great, very knowledagable and spent a lot of time explaining everything to me. I feel very comfortable with him. He has also done a lot of work w/ Parkinson's and has received several awards for it. He has recommended that I have a nerve block done. It will help incrcease the blood flow to the foot and decrcease the swelling; all in which will decrease my pain, hopefully! I get my cast off in 2 weeks from today and will start PT at that time. I'm scheduled for the nerve block next Tuesday and am nervous about it but hope it will help.