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Pain and Numbness to foot after ankle fusion.

by Drea
(Islip, NY)

I am a 44 yr old Female in excellent health. I was very athletic prior to my surgey, even with terrible arthritis from a crush injury to my right foot in 1995. I ran for years, not well...but I ran, and eventually developed a collapsed talus bone and extreme arthritis to my ankle bones. (all of them). The ankle autofused itself. Most Dr's wouldn't touch it for surgery and recommended amputation. One Dr recommended a specialist in MD and I went to see him. He offered a fusion or amputation. I elected after MUCH consideration, to try to fix it..even though my running days would be over. :( anyway, I had the sugery, with bone grafts and he replaced the talus with grafts and fused what he could. He cut the fibula permanently and inserted a 8" plate and 6 or 7 screws to hold it in place against my tibia..it extends under the bottom of my foot. I have O movement, but no big deal, as I have not had any for years...and still was able to run on it.

Fast forward 4 months+ and I am experiencing very little pain in ankle, YAY, but soooo much numbness and pain from numbness to the FRONT of my foot, where no work was done. It feels like someone cut off all circulation around the foot from the arch forward. Almost like an indian burn or like being in the snow for hours. It's 4am now and I am going insane from this feeling. I am almost wishing I would have done nothing, or done the amputation. I know it sounds crazy, but I just can't stand this non-stop numbness. At least before I could take meds and get some relief. NOTHING helps this. I use heat packs in my socks to try to keep my foot warm, but even that doesn't work. It's so cold and numb. Is there anything I can do to stop this? HELP. If it is nerve damage, can I do anything for it? Thanks for any help at all. - Drea

RESPONSE

Hi Drea,

Do not know if I am going to be of much help since your options are limited.
The good news it is "only" four months since your surgery so you are still in the acute phase of complications; eg: they are not chronic, yet.
So, this begs the question, have you had any physical therapy? If not, I would consider that an action you might want to take in an effort to improve your symptoms.
Post operative swelling would be one reason why you have the sensation in your forefoot that you describe.
The next possible option is to work with a pain management specialist, if you have not already done so as they are usually good at coming up with drug combos for different types of pain situations.
Additionally, have you had the circulation and nerve transmission coming into your feet tested? Although most the vascular and neurological structures enter the foot from the medial side, you need to make sure there is no compromise of circulation or neurological impairment that is giving you these sensations.
Lastly, and perhaps most importantly, you have to rule out CRPS (complex regional pain syndrome) which in its simplest description is a poorly understood neurological deficit that occurs generally after trauma and then immobilization. Surgery counts as trauma. You can read more about it here.
This is a condition that is best treated by a neurologist or pain management expert who is familiar with the syndrome.
I would suggest that you first rule this problem out and then work with either a neurologist or pain management physician to better control your symptoms.
I wish I could offer you more, but as I originally noted you have limited options here but hopefully you can improve on the present situation.

Marc Mitnick DPM
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Nov 16, 2015
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Foot/ankle fusion with numbness to toes
by: Drea

First I'd like to say thank you for those who answered my questions the first time around. I has a fusion 2 years ago (almost). I still have terrible numbness in my toes but it's not the constant pins and needles it was at one point. It is always numb however and that has taken its share of getting used to. Circulation is not great but a hot tub has helped with that. I have no pain in my ankle and as far as I can tell I'm one of very few people who continues to run marathon distances with a fusion after crush injury. I have a plate 12 screws and a severed fibula (never repaired) so it's been hanging in the wind so to speak for past few years. All things considered doing well I have been in pain management for some time for this injury and a nerve injury to my neck and shoulder. I take neurontin, and tzanadine to deal with nerve pain and fententyl and Percocet to deal with pain. I'd rather be without meds but that seems more unlikely as time passes. The only pain In the foot now is the numbness where years ago I couldn't even walk. I recommend it to anyone contimplating if they should do it or not. I didn't have a choice as it was that or amputation. It was a hellish recovery I won't lie. But it was well worth it.

Jan 07, 2015
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Pain in Front of Foot after TA
by: Anonymous

Yes, I can totally relate. I too had a triple ankle fusion, and really bad ankle from prior trauma.

I have same issues.

Ankle feels FINE! It's just the front of the foot, the bottom part, yes, like Indian burn/numbness on front pads...and the numb/burning toes (except big toe is mostly ok) and of course I also get the cramping on top of it.

I too am only 4 months into the surgery as I had it done 9/2014. I am still not full weight bearing as I lost an inch and am not set slightly equinus foot, so waiting on cobbler to get my right shoe built up before full weight bearing, still on crutches.

I had the titanium IM nail put up through bottom of foot. And I had to stop PT until the leg length discrepancy was fixed, then since I'm a solid fusion (can't move ankle at all) don't know that I will go back except to seek pain relief or have further testing on why front of foot hurts now.

Sorta danged if yeah do (had surgery for severe ankle pain, couldn't walk) and danged if you don't, now I still have pain and deformity to a certain degree, but hey, I still have my ankle so happy about that.

Sep 12, 2014
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Ankle fusion-Drea
by: Anonymous

I had an ankle fusion 4 months ago also. I have the exact symptoms of numbness and feeling as if the ball of my foot and all toes are frozen. It is painful and unpleasant. My surgeon doesn't seem concerned but then she isn't the one experiancing it. I too have improved ambulation and no pain in the ankle but the constant discomfort is making me nuts and I become depressed when I think this may not go away.

Mar 28, 2014
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numbness
by: Anonymous

I had my ankle fused June 2013.I can now walk much further than before the op and without the pain i was experiencing.
However I do have numbness in my foot,in my case it is the little toe and surrounding area.This may sound daft but a few months ago I was in a swimming pool that had high pressure jets of water entering the pool from the bottom like a hydro pool and i put my foot over it for a few minutes each day and the numbness almost went away.The numbness is as it was before now but i think if I could have continued the water jet treatment it would have solved the numbness.I think I have nerve damage and the water jets stimulated the nerves but who knows?Try it.

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