Leg Pain and Numbness After Orthognathic Surgery - Neurology

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After undergoing orthognathic surgery, it is not uncommon for patients to experience various forms of discomfort, including leg pain and numbness. Your symptoms, which include pain in the outer calf, swelling, sensitivity, tightness in the calf muscles, and tingling sensations in the foot, can be attributed to several potential causes.

Firstly, the prolonged duration of your surgery (over 8 hours) may have contributed to the development of complications such as nerve compression or vascular issues. During lengthy surgical procedures, especially those involving general anesthesia, patients are often positioned in ways that can lead to pressure on certain nerves or blood vessels. In your case, the discomfort in your right leg could be related to the compression of the peroneal nerve, which runs along the outer side of the leg and can cause pain, numbness, and tingling in the foot.

The symptoms you describe, particularly the swelling and sensitivity in the calf area, may also indicate the presence of a condition known as compartment syndrome. This occurs when pressure builds up within the muscles, potentially leading to muscle and nerve damage. Although this condition is more common in acute settings, it can sometimes develop after surgery due to swelling or hematoma formation. The tightness and pain you feel in your calf muscles could be a sign of this condition, and it is essential to monitor it closely.

Additionally, the tingling and electric shock-like sensations in your foot could be indicative of neuropathy, which can occur due to nerve irritation or damage. This can happen post-surgery due to inflammation or direct trauma to the nerves during the procedure. The fact that you have experienced these symptoms for nearly five months without improvement suggests that further evaluation is necessary.

Given that you have already consulted with various specialists, including traditional Chinese medicine practitioners, rehabilitation specialists, and vascular surgeons, it may be beneficial to seek a comprehensive evaluation from a neurologist. They can perform nerve conduction studies and electromyography (EMG) to assess the function of the nerves in your leg and determine if there is any underlying nerve damage or dysfunction.

In the meantime, managing your symptoms is crucial. Here are some recommendations:
1. Physical Therapy: Engaging in a structured physical therapy program can help improve circulation, reduce swelling, and strengthen the muscles in your leg. A physical therapist can also provide exercises tailored to your specific needs.

2. Pain Management: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen or naproxen), can help alleviate pain and reduce inflammation. However, consult your physician before starting any new medication.

3. Compression Therapy: Wearing compression stockings may help reduce swelling and improve blood flow in your leg.

4. Elevation: Keeping your leg elevated when resting can help decrease swelling and discomfort.

5. Regular Monitoring: Keep track of your symptoms and any changes you notice. If your pain worsens or new symptoms develop, seek medical attention promptly.

6. Follow-Up Appointments: Ensure you have regular follow-ups with your healthcare providers to monitor your recovery and make any necessary adjustments to your treatment plan.

In conclusion, while your symptoms may be frustrating and concerning, they are not uncommon after a significant surgical procedure. A thorough evaluation by a neurologist, along with appropriate management strategies, can help you find relief and improve your quality of life. Remember, recovery can take time, and it is essential to be patient with your body as it heals.