If your foot still hurts 6 months after surgery, a possible cause is a peripheral nerve injury that may have been present before the operation or could have occurred during the procedure.
Here's a more detailed explanation:
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Nerve Damage: Foot surgery can sometimes lead to damage of the peripheral nerves in the foot. This damage can cause persistent pain, even months after the initial healing period. This nerve damage can occur in a number of ways, but the following are the most common causes:
- Pre-Existing Condition: The nerve may have been injured prior to the surgery, and the surgery did not fix the issue, or even aggravated the underlying issue.
- Surgical Trauma: The nerve could have been damaged during the operation from cutting, stretching, or compression.
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Normal Healing Time vs. Chronic Pain: While some discomfort is expected after surgery, pain that persists for six months or longer is generally considered chronic and requires further investigation.
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Potential Causes: Although nerve damage is mentioned, other conditions can be the source of pain after surgery:
- Infection: Even if initial infection is gone, a smoldering infection can be the reason for the pain.
- Implant Issues: Pain can result from an implant such as a screw rubbing or irritating the surrounding tissue.
- Non-Union: If a bone was cut or fused it is possible that the bone did not heal properly.
- Scar Tissue: Scar tissue around a nerve or in the surgical area may be impinging on other structures of the foot and be the source of pain.
- Complex Regional Pain Syndrome (CRPS): Nerve issues can result in CRPS, which is characterized by intense pain and skin changes.
- Referred Pain: If there is another injury such as a back injury, pain can be referred to the foot.
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What to do: It is recommended to seek medical attention as soon as possible to assess the cause of the pain. To get to the bottom of the pain, the foot and ankle surgeon will likely:
- Physical exam: A comprehensive physical exam to help determine the location and type of pain.
- Review the surgical report: Understanding what the surgery was intended to accomplish, and any complications or deviations from the plan.
- Imaging: Typically x-rays are taken to assess the bones, alignment, and position of any hardware. Bone scans or MRIs may be needed to further determine the cause of the pain.
- Nerve Conduction Studies: Testing the nerve to assess its function.
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Treatments: The treatment plan will depend on what the reason for the pain is, but it might involve:
- Medication: Pain killers can help reduce pain, but will not fix the problem.
- Physical Therapy: To help strengthen the muscles of the foot and ankle and reduce pain and swelling.
- Injections: An injection to a trigger point or to a nerve may help reduce pain and inflammation.
- Surgery: The original surgery may need to be revised or the implant removed. Nerves can be released to help resolve the pain.
In summary, persistent pain six months after foot surgery can stem from a variety of factors. Consulting with your surgeon or seeking a second opinion is crucial for proper diagnosis and management.
