ankle fusion, with severe nerve pain and burning

Foot care
1

Hello, I am 2 days shy of being 5 weeks post-op. I had a tibiotalor joint fusion with 2 screws on either side. This is the result of a 22 year old fracture of my tib/fib that originally had a screw, 5 pins and a figure 8 wire. The hardware was removed 7.5 years ago when I suddenenly couldn't walk due to severe pain. I have been in pain since, developed severe arthritis, spurs, and floating pearl-like calcium deposits. The surface area of my tibia had become 60-70% hollow because when the joint collapsed and the cartilage was gone my bone absorbed the synovial fluid (joint fluid) within the bone for cusion; essentially the end of my bone was made up of 3 large cysts.

Now that I have that out of the way let me get to the problem. The burning and raw feeling I've had has been really intense. I told the doc at 1 week PO appt and explained I felt the cast was to tight around my metacarpals at the base of my toes and I was numb from my 3rd toe back and toward the outside of my foot. Numbness is pretty common (50/50), but the pain not so much. He said if it was looser I would likely get blisters from swelling; this made sense since I experienced blisters with the original break. At 2 weeks the burning intensified and I asked for more pain meds (I had Percocet) and I was denied and told to take lots of tylenol and Ibuprefen. At 3 weeks I called again for meds because I was having trouble sleeping and getting mentally drained from the feeling of rawness and burning and radiating pain. I thought I had blisters or sores but when I stuck a q-tip down to see if there was any evidence of that I couldnt feel it. He had me come in and removed my cast. I did have a few blisteres that dried up and minor bruising around the entire area that I have pain. I was sent home with my foot wrapped in cotton, ace, and self-adhesive wrap with a boot, but of course I am still NWB. 

Even the pressure from the boot causes irritation. Being upright feels better but it swells, having my foot elevated is nearly intolerable because the nerves don't stop firing. Ive got to the point where I am often laying or sitting with feet up level and no pillows for my foot and no boot. I will be fine most of the day but the moment I lay down my foot starts with the nerve signals. Last night I had been sleeping on my stomach with a pillow at my ankle so that my foot hung square without pressure (no boot). I finally got up at 1:am and went to the living room to watch t.v. and the pain almost immediately was tolerable. I unwrapped my foot completely so that i could rub on it. It felt so good but I worry that I shouldnt be doing this. I'm really hoping this nerve pain with improve sooner rather than later. I an concerned it will affect my ability to walk after my ankle is ready. I am also hoping that as the bruising, which is almost invisible, is the reason for the nerve pain. I have noticed I am able to wiggle my toes more and sweeling has reduced significantly since being able to take off my boot. i am forcing my self to keep my boot on today because the past 3 days I have rarley worn it. I have no ankle pain and I'm not worried about the positioning of my foot because the ankle doesnt move, but I realize I need to keep it better protected from the elements for a few more weeks.

I know this is a lot of info. Sorry if I gave to many details.

2

I did have bad nerve pain with my fusion as well and it does get better. I am 41/2 mo this out and have no nerve pain at all. I have some numbness of my big toe , but it is getting better as I walk and move it more.

The nerve pain goes away when you start to wb , but each week it should improve. Massaging your foot is good to help wake up those nerves and desensitize them. I had a really hard time sleeping too. It seems they fire up at night. Get at least some Tylenol 3 , regular Tylenol does not cut it. I k ow this is a tough part of recovery and is painful. Maybe ask about some drugs they have for nerve pain. My doc wasn't that great about giving me pain meds either, but I insisted and got Tylenol 3, which is non addictive. Even T1's you can ask at pharmacy and they will give you them without a prescription, at least here in Canada they do. My cold therapy machine I bought on Amazon really helped with nerve pain. Check them out online, I sometimes kept it on all night.

Good luck and hang in there, it does get better

Margie

3

I didn't have nerve pain as such so didn't need meds, but in the first few weeks my toes felt numb and uncomfortable in the plaster, and the top of my foot was still numb when I had the plaster changed at 6 weeks post op.The surgeon said this was probably down to the nerves being bruised.  However it was fine by the time I came out of plaster at 12 weeks and I have full feeling back in my foot and toes now, so I'm sure yours will all settle down too.  Now I just have the muscle pain when I walk!  Challenges at each stage, but let's hope it's worth it in the end.  

4

Thank you for the pep talk and advice.

5

I am really Hoping that it is just the bruising. I do wiggle my toes a lot a rub my foot now and then. I really try not to mess with it much because infection could destroy everything.

6

Hi Nichole. I had a brostrum procedure on April 28th,2017. I had splint on two weeks and the burning numbness was horrible. I got that off yesterday may 11th. If felt good to get it off. I asked the doctor about the burning and the numbness and he said that is totally normal and it takes quite a while for it to settle day on especially the numbness I'm not sure how long it takes the burning to go away he said it depends on if the burning is coming from the irritation of the rap cast boot Etc or if it is from the nerve pain from where the nerves were disrupted. I was put in a walking boot and told to weught bare as I could stand it according to the pain and swelling that I might have he told me to keep it elevated and iced when the swelling gets bad and to rest it when I need to. I can't stand to have the ace bandage or soccer anything wrap up against my foot because of the stinging nerve burning pain. It is awful and very aggravating and very discouraging. I guess it just takes time for everything to mend and go back to normal. I was very anxious to get the boot but so far I'm not loving it. I am glad that I can walk around a little bit laying around it's not what I usually do and I get bored very easily. So hang in there and we'll keep in touch and compare our recovery .Have a great evening . You can private message me anytime if you need some encouragement.