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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