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Neuropathic pain after orthopaedic surgery and shingles

Posted , 4 users are following.

danny_1989
danny_1989

Hi late April I has 6 hour operation to right leg. Insertion of new nail from knee, insertion of second nail from hip and bone graft from iliac to upper femur break which was considered non union.

2 days post surgery developed shingles right lower back. Itching, deep right lower back pain, numbness. However on left leg which was the untouched leg I had burning symptoms on inside of knee medial. Also some pain and burning near left ankle. Skin burned to touch or movement. Tightness in hamstrings and through calf and ankle

I went home after six days. By now mid may. Shingles rash falls off. Back pain gets better and residual numbness remains. However I have feeling of hot and cold on left leg below knee. Feeling like ant is crawling on skin. Gradually over week neurology symptoms improvE. Then 21 may I have revision surgery to femur about 1.5 hour surgery . Mistake of surgeon with osteotomy not cut all the way through. Then my neurological symptoms go crazy after surgery . Burning around inside or ankle area is so bad I cannot sleep, not even with heavy opioid. Tightness around hamstring and through calf and ankle. Thank God in last few days the ankle burning significantly reduced.

What can it be? I never had this before. All started post surgery. Orthopaedic surgeon said did not touch nerve or strap my good leg. Why all these symptoms below knee and ankle. Is it tied to the shingles. I will now start to take lyrica following suggestions from surgeon. Thank good it has improved. I am 5 weeks now post first big operation and 3 weeks post second smaller op. Was my sciatic nerve pinched or damaged. Surgeon has no idea. Any help please to find root cause. Can't do mri due to magnet and metalwork inside femur. Thanks

1 like, 9 replies

9 Replies

  • Merry19451
    Merry19451 danny_1989

    Posted

    Danny,

    You didn't mention your age, which would be helpful, or if you have any medical diseases or are immunocompromised. How long ago was the initial fracture? Did the fracture include the head of the femur? How did the injury occur, or mechanism of injury? What else was injured and when?

    Without knowing any answers to my questions, and without examining you, I can suggest the following:

    You have been through a great deal of stress with a femur fracture, nonunion, Open reduction, internal fixation of femur fracture, correction of femur fracture, plus Herpes Zoster-Shingles. Shingles can cross the midline in some cases, not often, but it does. It can also go to other dermatomes. Shingles without a rash is called "Zoster sine herpete." I would suggest you look up dermatomes on Google and see if the area where you had your pain coincides with the burning pain in Medial knee and ankle. Otherwise, you certainly could have injured yourself when you fractured your femur, causing a neuropathic pain similar to shingles. The neuropathic pain could originate from the lumbar sacral spine and/or nerve roots and when you had surgery. Lying on the OR table and walking non weight bearing, with your gait uneven, could have exacerbated the condition. It sounds as if it is neuropathic pain. I hope this helps you. I would see a neurologist. The other person to consult with is a vascular surgeon. Those symptoms can be caused by vascular compromise, as well.

    I am so sorry for your suffering. I have had Herpes Zoster Oticus in my right ear every three to five weeks for the last 20 years. I am a nurse practitioner in the States.

    Best Wishes

    Merry Juliana

    • danny_1989
      danny_1989 Merry19451

      Posted

      Hi and thanks for your reply. My age is 45.my initial femur break was two years ago. Since this time I have had 3 rods replaced. One broke, second screw broke and finally bone graft. I never had these symptoms until two days post op in all the previous 3 x 6 hour surgeries I had. I have no other diseases and can only think that there must be some relationship between shingles, surgery because prior to surgery I had no issue. Today I used me nerve problem leg a lot for walking on crutches and burning increased in foot area. As I said I am grateful symptoms going so I can focus on non union repair but really curious the cause. I went to one neurologist who was useless. He just said that I went 6 rounds with Muhammad Ali. To give it time but nobody says hypothesis for root cause. Thanks
    • Merry19451
      Merry19451 danny_1989

      Posted

      Danny,

      A lot of physicians are abysmally ignorant regarding Herpes Zoster-Shingles, and just plain useless, in general. Shingles can cross the midline, rarely. It would be strange to see one side with a rash and another part of your body without a rash, but if the pain was the same, I would certainly think that it was true.

      How did the injury occur?

      What do you do for a living?

      Merry Juliana

  • joyce01872
    joyce01872 danny_1989

    Posted

    Hi Danny,

    My goodness, you're dealing with a lot! I don't know about your surgeries, but I do know that shingles

    attacks only one side of the body...it can be any part on the body, but confined to one side.

    I had a really bad backache several weeks prior to my shingles rash breakout, and I don't ordinarily have back aches. The backache finally subsided; however, I am 4.5 months out from original shingles diagnosis and every few weeks I get classic flu symptoms that include backache...these symptoms last 4 to 5 days up to a week...this is post shingles.

    That's about all I can say that relates to your situation. Here's hoping you find answers to your questions, and that your condition is improving.

    Peace and Blessings,

    Joyce

    • danny_1989
      danny_1989 joyce01872

      Posted

      Hi thankyou. One day out from shingles I got bad headache post surgery. I also had this really strange tingling spasm from the right side of hip near pelvis across to just below belly button that lasted about 7 days. As I mentioned my shingles rash pain and numbness combined to right lower backback. I still have some residual numbness. As I said strange everything came same time but even stranger my good leg impacted.
  • danny_1989
    danny_1989

    Posted

    Update 18 June

    Started lyrica 7 days ago. Ortho surgeon gave for right leg surgery pain but said will help left leg neuro symptoms.

    Burning in ankle inner foot area reduced a lot. Still have shooting pain time to time. Physio confirmed half way down lower leg to ankle I have some numbness because I could not differentiate pick from blunt instrument and hit from cold.

    Main symptom now is tightness in lower leg knee down. Mainly behind knee. Behind calf feels like I'm wearing sock. Accupuncture helps.nothing else does.not physio or chyro or remedial massage. I hope it goes. So things improved a little. Some say it could have been shingles causing this others says impossible to go past midline

    • Merry19451
      Merry19451 danny_1989

      Posted

      Danny,

      As I stated before, Herpes Zoster-Shingles occasionally goes past the midline. I believe I said it could also be attributed to nerve root pain or disc pain. It is difficult to ascertain without a history and physical. Certainly, you can have "Zoster sine herpete," or Shingles without the rash.

      I hope this helps you.

      Best Wishes

      Merry Juliana

    • danny_1989
      danny_1989 Merry19451

      Posted

      Hi thanks. So if I understand what you are saying on day two post operation when I had confirmed shingles in right lower back with a rash I could also have had another shingles on left lower leg without a rash?
    • Merry19451
      Merry19451 danny_1989

      Posted

      Yes,

      Or sciatica, but that is difficult for me to say as I wasn't feeling the pain. If it felt like the other side with shingles, then yes, it could possibly be shingles-zoster, recurrent, if it happend a few weeks after the initial episode. Medicine is still an art, and a clinician combines the history and physical to come up with a diagnosis. The tests only should confirm the diagnosis. I am only here to support the people and make suggestions. I cannot diagnose over the phone and obviously cannot treat you. You need to see a specialist who knows what he or she is doing.

      Best Wishes

      Merry Juliana

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