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Constant burning pain/numbness in thigh after knee arthroscopy

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Just trying to find some answers about this, as my doctor has been less than useless. I'm 2.5 months post-op, knee fully recovered, and back to normal function.

About a 3 weeks post-op, give or take this started. My thigh continually experiences a surface numbness, coupled with deep, burning pain. It's especially worse when I lay down to sleep, the thigh is in a constant state of "pins and needles" that is so intense and painful that it keeps me awake for hours, and I have to take sleeping medication to get to sleep. Once asleep, it constantly wakes me up throughout the night. In every other state (standing, sitting, walking) the thigh is in constant pain, enough that it makes me lose my balance occasionally.

My doc has been, like I said, completely and utterly useless. He talks like someone afraid of lawsuits, and has told me separate stories on separate occasions. He's blamed the tourniquet from the surgery, he's claimed that it's "all in my head and I'm not in any real pain", and he's also said "Well, it's probably something else and has nothing to do with the surgery, because I didn't cut in your thigh", and finally "I'm sure it's nothing."

I've never had any pain in my thigh like this prior to getting the surgery. I'm quite afraid I've traded a manageable pain (the knee) for a nearly totally unmanageable pain. It's far worse than the pain the surgery was intending to fix.

At least on the plus side, my knee doesn't hurt anymore.

Any similar experiences? Am I stuck with this the rest of my life? He keeps telling me he's sure it'll be fine, but every day that passes it gets worse.
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First Helper sylar

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replied October 2nd, 2012
Especially eHealthy

From your description, it sounds like you have an almost classic resolving neuropraxia from the use of a tourniquet.

A pneumatic tourniquet is used in all types of extremity surgery, to help with control of bleeding, so that the surgeon can see the field. Before the advent of the tourniquet, the surgeon has to continuously swab and pat the tissues so that he could see the structures in the surgical field. This damaged the tissues and also made the surgery just that more difficult and dangerous. Arthroscopic surgery essentially could not be done without the assistance of a tourniquet.

So, the use of a tourniquet is routine in almost all extremity surgeries. It has been proven safe and effective. There is a known range in which the pressure should be kept and the amount of time which it can be kept up. However, every patient’s nerves react to the pressure from the tourniquet uniquely. Some patients develop a neuropraxia after just a few minutes and at low pressures, while others can withstand extremely high pressures and an extended amount of time.

You must likely have had some numbness around the thigh since the surgery. But, since you were having discomfort in the knee, or you had a dressing over the knee, it was not noticeable to you. Then, when the nerve started to wake up (around 3 weeks is about right; it is usually within a period of 2 to 4 weeks). When the nerve wakes up it goes through a predictable set of symptoms, to include pins-n-needles, tingling, and a burning type of pain.

If you have ever sat on your foot, until it went totally asleep, and then allowed it to wake up, this is analogous to that. Contrary to what our mothers told us, when you put your foot to sleep, it is not because the circulation was cut off, but rather, there was pressure on the nerves. When the pressure was released, the nerves slowly wake up. If you have ever done this, then you will know the sensations the foot goes through when it wakes up. There is that certain time period where the “feelings” are so intense you do not want to touch the foot, but it finally passes, and the foot wakes completely up.

So, you are now in that period where the nerve is regaining most of its feelings back, it is waking up. How long this takes varies between patients. It usually only takes a couple of weeks, but can take longer (or shorter).

You can try to desensitize the area by rubbing it with different textures, of differing roughness. But, usually, you just have to wait it out.

There are a couple of medications that may help with “nerve pain”, they are Neurontin (gabapentin) and Lyrica (pregabalin). If the feeling is too much for you, you might ask your surgeon/physician if you could try one of these medicines.

Good luck.
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replied September 16th, 2014
I just had my knee arthroscopy on 9/15/14 and im already experiencing the burning and pins and needles in my knee and thigh. Is this normal? Not getting any sleep.
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replied December 2nd, 2014
You should take your regular sleep and if still don't find any change in the pain then consult your physician or surgeon who handled you=r case.
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