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Hi Guys,
Just wondering if I could please call upon some very much needed help.
I've just had a physio colleague come and ask me to look at a patient who has had a hip operation 5 days ago on the left leg and is now complaining of a burning sensation down the whole length of the achilles tendon which is keeping him up at night, disturbing his sleep and also getting him down a bit.
Is there any obvious reason that could be causing this or am I just being silly and missing an obvious point here?
Relevant Case History
57 year old patient
First Major Surgery for Osteoarthiritic Hip (total replacement), walking was greatly inhibited by problem before replacement and patient sometimes required 2 sticks to walk
Signs of Arthiritis in other hip and also in both knees.
Very active individual before arthiritis set in with frequent marathon running and cycling. Also very regular at gym.
Previous job as postman required lots of walking
Currently resting hip and in very early stages of rehab following surgery

Any help much appreciated all :)

Thanks

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

Neural?

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

Hmm yes does sound that way a bit doesn't it. At the moment I've just advised him to keep moving the foot up and down which does seem to relieve the pain as he can also get it at rest when sitting in the chair or lying up in bed. It never happened before the surgery I hasten to add, should have put that in the initial thread starter
Any other valuable advice to give this lovely patient?

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

Hi
? surgically induced leg length difference.

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

Hi
? surgically induced leg length difference.
Regards

Deborah

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

I'd be looking further away from the TA and more towards the lumbar spine. Sometime the positioning or manual handling during and surrounding surgery can induce lumbar disc distortion. Night pain, cough/sneeze pain, positive slump??.....think disc.

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

I was thinking that also but would that cause a burning sensation down the achilles non-weightbearing? The gentleman in question isn't walking much at the moment apart from the usual ADL

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

It might do - think dermatomes.

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

Sure would if this is an inflammatory disc issue. NWB disc related discomfort usually = disc infl

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

This does sound similar and is a really helpful post so thank you, I don't know about the cough pain and will ask but I do know that the patient is reported as having a kyphosis before surgery and also pain in the sterum for approx 3 years which inhibited his sleeping for years and he would frequently get up at night as he was too uncomfy to sleep
However, this is resolving following the surgery and no pain reported since, with the exception of the TA? Sorry I'm throwing a spanner in the works here aren't I?

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

*smacks head* :bash: of course dermatomes!!!!!!

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

My guess?....L5-S1 radiculopathy due to disk protrusion onto nerve roots.

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

Ahh...is that something that will go as time goes on and the hip heals or does he need to go back to his doc/consult his surgeon?

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

Unless he has reduced reflexes and sensation it is likely that this is an inflammatory radiculopathy rather than a mechanical radiculopathy at L/S.
Treatment: manipulation above L/S, NSAIDs, MeKensie extension exercise won't hurt plus core stability and time (about 10/7).
D.

 

Re: BURNING ACHILLES TENDON AFTER RECENT HIP REPLACEMENT

I would suggest a month with a good physical therapist/physiotherapist and/or chiropractor.