One major cause of complications after surgery in the lower extremity is nerve entrapment (nerve compression) in or near the scar. This can be the cause of much frustration for the doctor and especially the patient. Some typical examples we see every week are: pain in the ball of the foot after neuroma surgery or pain radiating down the leg to the foot after knee surgery, or persistent heel pain even after plantar fascia surgery. Lateral ankle surgery can be a problem as well. Nerves are very touchy and a perfect surgery can result in nerve irritation that feels just miserable.
How is nerve pain diagnosed after surgery? What does it feel like?
The pain starts fairly quickly after surgery and feels differently than the pain before the surgery. Most often it is a burning or tingling pain. A good clinical exam will identify the level of the problem. Usually the nerve lesion area is very sensitive to the touch and causes pain to radiate either up or down the leg or foot. Sometimes there is loss of sensation. Sometimes the skin looks different.
What can be done?
That depends on the nature of the injury and the length of time since the injury. Sometimes (especially after knee surgery) the fix is simple. Just take pressure off the nerve it usually heals quickly without much interruption in your life. In the case of neuromas that have been taken out and come back or still hurt this can be treated with a “mini-neurectomy”. This is really rewarding to do because the incision is so small the patient can walk out and take the dressing off in one day and return to normal shoes with a band-aid.
In the cases of nerve damage sometimes the nerve needs wrapped with something to keep it protected from scar tissue. There have been remarkable improvements in nerve repair and now with microsurgical techniques and instruments and innovative products the success of these surgeries is becoming much more favorable.
So if you have chronic pain after a surgery or injury that is affecting your feet please give us a chance to help.