Do my symptoms sound like CRPS after ACL reconstruction?

Brain and nerves
1

Hi Everyone,

3 weeks ago I had an ACL reconstruction. The surgery went well and my knee is looking and feeling great! I had a femoral nerve block which they believe may not have worked as I was in a large amount of pain after surgery and I spent a few hours longer than I was supposed to in recovery.

About a week after the surgery (just as I started trying to walk without a crutch), I started having a sharp pain that came from the inside of my ankle. I ignored it at first, but it starting getting worse. After a few days, I started having electric shock pains radiating up my leg from my ankle and the area became very sensitive and felt like it was burning. Around this time my shin just below my knee also had similar symptoms (burning and sensitivity to light touch) and recently I've also had electric shock pains radiating from it. Both are sensitive to having blankets on them or going into water. It's painful but I wouldn't say it was excruciating. The burning and sensitivity to light touch happen when I'm sitting down and the electric shock pains only really happen when I straighten my leg and the first few steps when I start walking.

A few days after that I started having tingling and burning in my two outside toes of my operated leg and that had now spread to the soles of both of my feet.

All these pains get better when I start walking around for a couple of minutes. The longer I walk around and do my physio exercises the better they get. I can touch all these spots and the pain usually subsides for a second as well. Hard pressure seems to be much better than soft pressure.

My doctor put me on Lyrica (100mg in the morning and 100mg at night). This seems to have worked quite well. I'm not pain free, but it's much less noticeable - although the tingling in the soles of my feet isn't really affected by the Lyrica. It only started when I upped my dosage of Lyrica - so I'm not sure if it's just a side effect.

My surgeon believes I may have CRPS, as he was adamant he didn't go near any nerves, but every doctor and physio I've seen doubts that's true. I don't have any skin discoloration, swelling or temperature changes. From what I've read CRPS is not something you'd want to have.

Can anyone who is familiar with the condition comment on weather they think my symptoms are related to CRPS? It's really starting to worry me that I might have it. I'm trying to keep active and I've started working from home to take my mind off it. Has anyone else had something like this after surgery?

2

I have Crps type 2 caused by a brachial plexus  nerve injury during surgery, I get the stinging electric shock and stabbing pains. I have cold type so my hand wrist and elbow freeze , Lyrica doesn't do much for me , I had a stellate ganglion nerve block that worked but it didn't last long , I had another one that didn't work at all. I sure hope you are not another victim of this horrible syndrome.. keep me posted I have only had mine a year now 

3

That sounds awful! I'm so sorry

I also hope that I don't have CRPS. When did you first start noticing symptoms? What were your initial symptoms?

4

I knew right away something had happened, I had rotator cuff surgery and the dr could not reach the tendon with a scope so he cut me , after surgery while the block I had was still working I had a terrible twisted feeling in my arm like my arm was wound like a rubber band , when the block finally wore off I felt nothing in my arm it was like the block never wore off at all my arm was useless could not use my hand or arm at all took 4 months of physical therapy three times a week to get some use back.  My arm also got cold in only certain spots which was weird but it was a bone chilling freeze like an ice pack sitting on my bone that still happens , I also have a contant burning hot to the touch on one side of my neck and on the injured shoulder that randomly pours sweat, all due to the sympathetic nerves that are out of whack now. In all honesty I feel now that my arm is not mine anymore I actually think my brain has disassociated its self with my arm , I know that may sound crazy but it's not unusual to feel that according to my pain management dr, I can't tolerate pain meds or gabapatin and can't take Lyrica daily as for some reason it makes me energized and I really can't sleep on it, than again my sleep has never been good since my nerve injury. I wish you the best of luck and groups like this really help 💕

5

It does sound like CRPS  :-/

Doctors are saying I have CRPS too, due to a surgery on my knee I just had in September.. 

Ive had test done following surgery and ill get to that in a sec..

Im only 23 years old 😔 I am having the exact same symptoms as you AFTER my Right Leg ACL Reconstruction W/ Hamstring Graft and It is painful...Im going on 7 weeks post op recovery today... 

I get these Electrical shocks in my inner and outter part of my leg.. My calf is sore and sensitive to touch at times... Foot burns and sweats... Ankle feels like I rolled it 10x... Big Toe hurts all day and night.. I havent been able to sleep much since surgery. 

I can put weight on my leg but, I feel like my knee is going to give out at times so Im still on crutches no brace..(Thinking my quads are still weak)... Also when i try to pick my leg up and walk, I get this weird tingly/shock on the inner part of my leg.. I dont know what that is. 

I thought the surgeon mightve messed up my nerves but I guess not..

I just had a EMG done and my nerves are all okay they said, responding well..

 I just had another MRI on the knee that was operated on to see if anything went wrong so Im waiting on results this week..  Ive had blood work done for blood clots in my leg (calf soreness) and everything was okay as well.. 

For pain management I was taking gabapentin 400mg , Tramadol 50mg , Norcos, but I stopped taking all of that because it was giving me headaches and I felt like it wasnt working anyways!! 

The pain was so bad I said F**k it decided to go with a series of  3 shots near my spine (crazy right), I got them done at UCLA and it is called a (Lumbar Sympathetic Nerve Block) , just did my 2nd one yesterday .. Honestly, the 1st shot did take away some of the pain and took some of  the burning ontop of my foot away .. But It started coming back like the a day or two before I went to get my 2nd session of the shot...I still feel all my OTHER symptoms.. Maybe these shots really take time but Im not seeing much progress which sucks because people are telling me it should help.. If these shots dont work I really dont know what to do besides medicine and therapy..Seems like those are the only options i have left after these series of shots.

Sucks to really be diagnosed with this because they say it doesnt go away and there isnt a solution for it.. Its like theres nothing you can do about it but hope time heals it.. Have to remain positive though , but its not easy!

If my MRI doesnt show anything, I guess my leg/foot/knee is just really traumatized from the surgery and my body (nervous system) is responding to that..

 

Hope this helps you.. Im just sharing my story.. Feel free to let me know how you are doing as well! 

If you learn anything new about this or recover from your symptoms please let me know .. Id appreciate it a lot.. 

Thank you! 

6

I had ACL reconstruction with a hamstring and cadaver graft combined. Right after surgery I noticed electric shocks in my middle toe of the same leg when I would twist my ankle from side to side. I asked the surgeon about it and he figured maybe the way they had my leg tied up caused some minor nerve damage but that it would get better over time. 2 weeks post-op and my adjacent toe swelled up tight and bright red, with glossy skin. I figured I needed to keep my leg up more. After another 2 weeks my big toe and then other toes also swelled red and were so burning and itchy I couldn't concentrate at work and I wanted to rip them off my foot. My physio suggested RSD and my Dr. confirmed it and a 30mg does, 4 times a day of Gabapentamin has helped. The burning/itching is gone and the inflammation is down, but still hanging around. Cold temps seem to really affect the affected toes, and the drugs wear off in the night so by morning I can feel symptoms coming back. I know my symptoms could be a whole lot worse but it seems strange to have a knee that feels great 8 weeks post-surgery and toes that weren't touched to feel so off. 

7

Hey, 

I am finding myself feeling the same exact way. I am seeing that it’s been 4 month since you last posted. Can you please tell us how you are feeling now, what has helped, etc. 

Sincrerely hope you are feeling better, 

Irina 

8

Hi, after ACL reconstruction the most common complication is damage injury to the infrapatellar branch of the saphenous nerve. On rare occasions injury to this nerve will give rise to the exact symptoms you have burning pain electric shock is neuroinflammation. Around the scar area is this nerve it's called for short ipbsn, check online for a condition called infrapatellar saphenous neuritis. It is a specific rare complication from A CL reconstruction surgery. It can happen with the nerve entrapment from a neuroma, which is scar tissue from your operation the nerve tried to regenerate and nerve endings gets caught in a ball of scar tissue. It is extremely painful. Also this leads to nerve entrapment and scarring of the nerve. It is well known it you leave this injury it can lead to CRPS. Medication does not solve the underlying problem. You need to see a pain specialist who will diagnose this methods include diagnostic injections, nerve conduction studies, then treatment not medications. Treatment they do is they can with the neuroma cut the ball scar tissue cap it and then put the nerve into the muscle to avoid another neurom a growing, or lysis of scarring , cryothereapy which is freeze the nerve, or ultrasound guided needle localisation. Get this done as soon as possible the longer you leave it underlying conditions such as low grade inflammation you will get and then you get symptoms from symptoms etc. Then you will most likely be diagnosed with CRPS. Make sure it's not this nerve and if it is get immediate treatment. Medication masks the underlying problem. Hope this is helpful. You will be diagnosed probably with allodynia and paresthesia, hyperalgesia etc. But if it's this nerve ipbsn get treatment. Hope this is helpful. You can make a full recovery. Not many people are aware of this complication as I said earlier check online it's called infrapatellar saphenous neuritis. Sounds exactly like your symptoms

9

Hi I am experiencing similar symptoms to you and I was wondering if they ever went away for you. Since it has been three years, I hope you are a lot better now. Thank you!

10

Hope so you are feeling better now.
I would like to know what was the actual reason behind it . what was the treatment taken to cure this problem.
because few days back my mother has got the left leg acl reconstruction and she is facing the same symptoms.
It will be really helpful if you can respond to us.
Thank you.

11

Hope so you are feeling better now.
I would like to know what was the actual reason behind it . what was the treatment taken to cure this problem.
because few days back my mother has got the left leg acl reconstruction and she is facing the same symptoms.
It will be really helpful if you can respond to us.
Thank you.

12

They never really found a reason. One specialist had an idea that the nerve block didn’t work (based on some things that happened in recovery) and my nervous system went haywire from the uncontrolled pain I experienced. I take 50mg of Nortryptyline which manages my symptoms. I now live a pain free, normal, active life. I occasionally get some weird nerve symptoms like burning or redness in my hands and feet but it happens rarely and hardly ever lasts longer than 10mins. I also weirdly developed Reynauds after surgery which I’ve had ever since. I’m on Nortryptyline to manage cerviogenic headaches I started having after a car accident I had 6months after my surgery. I do believe the headaches were linked to both my whiplash injury and the nervous system condition I developed after my ACL surgery as they followed the same pattern of resetting with sleep and starting midday and getting worse over the course of the day. I never had CRPS and the ACL surgeon that tried to diagnose me was an idiot. With time, the nerve symptoms and electric shock pains subsided as the swelling went down and my nerves healed.

13

They never really found a reason. One specialist had an idea that the nerve block didn’t work (based on some things that happened in recovery) and my nervous system went haywire from the uncontrolled pain I experienced. I take 50mg of Nortryptyline which manages my symptoms. I now live a pain free, normal, active life. I occasionally get some weird nerve symptoms like burning or redness in my hands and feet but it happens rarely and hardly ever lasts longer than 10mins. I also weirdly developed Reynauds after surgery which I’ve had ever since. I’m on Nortryptyline to manage cerviogenic headaches I started having after a car accident I had 6months after my surgery. I do believe the headaches were linked to both my whiplash injury and the nervous system condition I developed after my ACL surgery as they followed the same pattern of resetting with sleep and starting midday and getting worse over the course of the day. I never had CRPS and the ACL surgeon that tried to diagnose me was an idiot. With time, the nerve symptoms and electric shock pains subsided as the swelling went down and my nerves healed.