Irritated nerve in foot after total hip replacement

Hi teabagwoman- well this could be me!! So pleased to read your post (but sorry for your pain) I had a THR 7 weeks ago and have had problems with my right ankle & foot ever since. Like you, it keeps me awake ar night and is actually more bother than the hip itself! I am seeing my hip surgeon in the morning for my follow up and this question is top of my list. So I will feed back any advice/reassurance. He did question whether I now had one leg a bit longer than the other following surgery so maybe that is causing it, we will see. I hope you find some relief, though the regular paracetemol don’t seem to touch it for me. Hopefully not a permanent change and something that will fade with time & physio.

aquafish, I’ll be interested to see what your consultant says. Both my consultant and physio kept telling me “it was early days” and would “settle in time”. Sorry to be depressing but in my case it’s slowly got worse and I find that I have to restrict how far I walk as exercise means more pain in the night.

Hello again. I saw the surgeon this morning who was very apologetic that he made my right leg 6mm longer! He explained why and I know you have to accept the risk as a normal part of surgery. To be honest I wouldn’t know & he said how well I was waking. I asked about the foot/ankle pain, he examined it & seemed it think it could be arthritis in the ankle. He will see me again in 3 weeks & re Xray the hips & ankle. I’m not too worried and hope it just settles in time as early days for me.

It might be wise to seek a second opinion
I might sound cynical but about seven years I broke my wrist It was a bad break that had to be pulled to be realigned
The dr I saw when it was taken out. Of the cast told me I had stage 4 arthritis. Wrist was a funny shape.
Any way I had lots of physio and progress was extremely slow. Several months after it came out of the cast when visiting a friend in London I went to see a specialist physio who basically said only thing wrong was bad casting With a lot of work on my behalf there is a slight crackle if I really push it but nothing to speak of oh where is the stage 4 arthritis?

Aquafish I’ll keep my fingers crossed for you. I’m hoping my gp will agree to x-raying my ankle. Today is the first time I’ve had pain during the day so my ankle is definitely getting worse.

Trapped nerve? I had nerve pain after a broken wrist which had not been set properly. Carpel tunnel surgery helped in my case.

aquafish

Hello again. I saw the surgeon this morning who was very apologetic that he made my right leg 6mm longer! He explained why and I know you have to accept the risk as a normal part of surgery. To be honest I wouldn’t know & he said how well I was waking. I asked about the foot/ankle pain, he examined it & seemed it think it could be arthritis in the ankle. He will see me again in 3 weeks & re Xray the hips & ankle. I’m not too worried and hope it just settles in time as early days for me.

My consultant warned me that it was always a possibility that the leg would be slightly longer or shorter after the operation. It depends on how they re-attach the muscle I believe.

Humbertbear. Thanks for your reply. Yes its a risk you take for sure as its not an exact science fitting a prosthetic joint. Thankfully mine isn’t noticeable or painful and within the accepted range of under 10mm. Onwards and upwards!

Sound like Nerve pain... Years ago after an Epidural injection, I had issues of tingling strange sensation down inside of my Right leg. It was documented in my notes, as a bit of nerve damage, did you have a Spinal anesthetic?
Nothing was done about mine , it took a good year to disappear.

Indeed Visgirl, I did have an epidural, hadn’t really thought about that. I’m glad it did eventually resolve, that’s encouraging.

I had my hip replacement in January and I had a general anaesthetic. They apparently use a nerve block injection these days to try and reduce pain for immediately after op, they didn't when I had my other hip done in 2022, this has given me a lot of nerve problems too. I have been told by the physios that it is a common side effect to have nerve problems after these injections, they are likely to last any time between 3 and 12 months. After around 6 weeks of pain, burning and lack of sleep I spoke to my GP who offered me pregabalin. I take one 100mg tablet before I go to bed and this is sufficient to enable me to sleep through the night and like the OP it doesn't affect me too much during the day. I have not been tempted to increase the dose at all and don't appear to be suffering any side effects.

Oh dear. This terrifies me as I’m at the stage where Im considering hip replacement. My MIL ended up with one leg longer than the other.
Can I ask where you all had your hip replacements done? I’m in Staffordshire.

Robin202

Oh dear. This terrifies me as I’m at the stage where Im considering hip replacement. My MIL ended up with one leg longer than the other.
Can I ask where you all had your hip replacements done? I’m in Staffordshire.

Don't worry... I have had both my Hips done and a Knee it's the best thing. I don't have odd size legs.. Tbh never gave it a thought as it's not a common problem.
Best of luck

Very interested in these posts having been referred to ortho with severe arthritis in hip. Have heard that surgeons in national centre will only operate with general anaesthetic. Interesting about the leg length issue. Referred 5 months ago, still 4 months to go for consultation then 1 year wait if surgery recomended. Pain is getting worse and leg is giving way more often.

What 'national centre' would that be, 4allweknow?

I had to wait 4 months between referral and operation. It could have been even sooner, I had turned down 2 cancellations in the interim because of booked holidays. In hindsight, I should have taken one of them because the discomfort in the early recovery period was far less than the previous hip pain.

I did have one leg (the one with the arthritic hip) shorter than the other and requested that they ended up the same length. Which they have done. I don't know if they would have done anyway even if I hadn't requested it.

I had an epidural with sedation. I thought that was pretty standard these days?

I had a full knee replacement and after about 6 months I got nerve pains in my knee like being stuck with pins. I mentioned it to my consultant and he said it was because the nerves were waking up and it will pass. Suggested gentle massage. It did go but took around 6 months. Ask your consultant. I'm sure this will go. Best regards.

I will try gentle massage JoeyJo and see if that helps and I’ll ask about Pregabalin.

I’m sorry if this thread is worrying GNs who are waiting for a hip replacement. I could do without being woken in the night with the pain in my foot but it’s a lot better than the constant pain and exhaustion from my arthritic hip.

Robin 202. As you live in Stafford are you by chance going to Gobowen I had both my hips done there and my legs match. I live on the Llyn Peninsular in north Wales and I know of many folks who have had knees and hips done there and I know of no one who had had problems including one of the GP s dads on the other hand of those I know whose surgery was undertaken more locally quite a number have had problems of the type mentioned above. No guarantee to my comments just hear say !!

Nerve pain. Often a nerve higher up gets irritated and this causes tingling, a bit ike some diabetics get. That should pass in time. I was told nerve healing can take up to a year / 18 months but that was about quite severe damage. I’d be wary of pregabalin or gabapentin. They didn’t help me and they are powerful drugs with their own risks, but of course it depends how desperate the discomfort is, you may want to try anything! I had a damaged stretched nerve from a hip replacement revision and terrible nerve pain and couldn’t safely stand for a year. Now 75% recovered.

Robin202

Oh dear. This terrifies me as I’m at the stage where Im considering hip replacement. My MIL ended up with one leg longer than the other.
Can I ask where you all had your hip replacements done? I’m in Staffordshire.

I'm a bit behind you as I'm at the stage of thinking I really must see a GP about hip pain as it's become too much of a problem with restricted movement and constant aching. have heard many tales of different sized legs afterwards but did not know about the nerve pain so many seem to have afterwards. Also concerned about immediate aftermath as I live alone and have no-one who could help me, or will I need help?

Marjgran

Nerve pain. Often a nerve higher up gets irritated and this causes tingling, a bit ike some diabetics get. That should pass in time. I was told nerve healing can take up to a year / 18 months but that was about quite severe damage. I’d be wary of pregabalin or gabapentin. They didn’t help me and they are powerful drugs with their own risks, but of course it depends how desperate the discomfort is, you may want to try anything! I had a damaged stretched nerve from a hip replacement revision and terrible nerve pain and couldn’t safely stand for a year. Now 75% recovered.

I was very apprehensive about using pregabalin for my nerve pain, but my GP said that it has less side effects than gabapentin and he suggested I try it on the low dose and increase it if I felt it helped and the side effects were bearable. There comes a point where you have to decide which is worse side effects (of which I haven't had any) or the nerve pain and lack of sleep. I have no intention of increasing the dose as it is working well enough for me on the low dose. Having a good night's sleep is so important when you are trying to recover from surgery it sets you up for the day ahead.

I haven't had a big operation like a hip replacement, but I did break a toe eight years ago. It healed ok and I had no more trouble till about 4 months ago when walking started to be difficult.
Long story short, for me it's something called Morton's Neuroma. It's thickening of tissue around a nerve in the foot. It seems I will be given a steroid injection or might have to have the offending nerves removed altogether.
My physiotherapist has lent me a walking stick and it has made life a lot easier.
I hope you get sorted soon. All the best.

very interesting. I had a TKR 5-1/2 months ago and found my foot on same side is now 1/2 shoe size larger than other so have to buy new shoes. A friend who has had 2 THRs had one leg longer than the other. I also think I’m becoming flat footed on same side as TKR, and again, apparently it’s normal.
So there you go!!

I had a THR posterior in January - the surgeon has to cut through muscles and nerves to access the hip and the muscles & nerves can take months to settle completely - I had nerve pain limited to the surgery area and I can sympathise with just how sharp the pain can be - It's now April so almost 3 months to the day I had the op and for me it has settled. If you are experiencing pain in other areas I'd seek medical help in case it is unrelated to the original surgery.