Causes
Nerve damage after foot surgery: signs, timeline and what helps
Some numbness beside a new scar is part of healing. Spreading numbness, burning or electric pain, or a scar that zings when touched points to an injured nerve.
Written by the Managing Neuropathy editorial team under the direction of Dr. Tom Biernacki, DPM, FACFAS · Clinical review pending · Last updated 26 September 2026
The short answer. A small numb patch beside the scar is common after foot or ankle surgery and usually improves over months. Signs of nerve damage are different: numbness spreading into the toes or along one edge of the foot, burning or electric pain, pain from light touch, or a scar that tingles when tapped. Damaged fibers regrow about a millimeter a day, so recovery takes months. Go to an emergency department for pain far worse than expected, and call your surgeon at once about pale, blue or cold toes.
Signs of nerve damage after foot surgery
Some change in feeling near the scar is expected. The pattern shows when it is more. How nerve pain feels different.
| Usually part of healing | Signs of a nerve injury |
|---|---|
| A numb patch beside the scar that slowly improves | Numbness spreading past the scar, into the toes or along one edge of the foot |
| Soreness and swelling that ease week by week | Burning, electric or shooting pain, or pins and needles |
| A scar that feels tight or slightly sensitive | Pain from light touch: a sock, a shoe, the bedsheets |
| Tenderness that fades as the wound heals | A spot on the scar that sends tingling along the nerve when tapped, or hurts under a shoe or strap |
Signs of nerve damage after bunion surgery
The main nerve at risk, the dorsomedial cutaneous nerve, supplies the top and inner side of the big toe. Numbness, tingling or burning there, a spot on the scar that zings into the toe when tapped, or pain where the shoe presses on the scar points to this nerve.
Get urgent help for these
- Go to an emergency department for severe pain far worse than expected, especially if the foot or leg feels tight and moving the toes hurts more: possible compartment syndrome, a surgical emergency.
- Call your surgeon now if toes in a cast, splint, boot or dressing turn pale, blue or cold, or go numb or stop moving once any nerve block has worn off. Loosen any strap you are allowed to adjust. If you can’t reach your surgeon straight away, go to an emergency department.
- Call your surgeon today for a temperature above 100°F for more than four hours, spreading redness, or pus-like drainage.
- Get seen as soon as possible for calf pain, swelling or warmth, possibly a blood clot. Call 911 for chest pain or sudden breathlessness.
- Call your surgeon right away if you can’t lift the front of your foot. About foot drop.
Complex regional pain syndrome (CRPS) needs a prompt call too: burning pain far stronger than the operation explains, skin that hurts to touch, and changes in color, temperature, sweating, swelling or stiffness. Treatment usually works best when started early. Estimates vary with the method: 4.36 percent of 390 people in a review of records after elective foot and ankle operations (2014), and 0.20 percent within a year of inpatient operations anywhere on the leg, counted from diagnoses in German insurance claims (2024).
Why it happens, and which nerve is at risk
Small skin nerves lie near almost every foot and ankle incision; a cadaver study of eight standard approaches found none free of them. An incision can cut one, and retractors holding tissue aside, or the leg’s position on the table, can squeeze or stretch one. A tourniquet, the tight cuff that keeps blood out of the operating field, can press on nerves, as can swelling or a tight cast, splint or boot. Later, scar tissue can tether a nerve, or a cut nerve end can form a neuroma, a tangle of regrowing fibers that can be intensely painful.
The nerve block that numbs the leg rarely causes lasting damage. The UK’s Royal College of Anaesthetists (2024) says fewer than 10 in 100 people have temporary nerve symptoms after a block, most recovering within four to six weeks, and puts permanent damage at 2 to 5 in 10,000.
| Operation | Nerve at risk: where you feel it | Reported nerve problems |
|---|---|---|
| Bunion correction | Dorsomedial cutaneous nerve: top and inner side of the big toe | Altered sensation after 0–45% of open and 2.4–15% of percutaneous corrections (2026 review) |
| Ankle arthroscopy | Superficial peroneal nerve, at the front-outer portal: top of the foot | About 2% of 7,942 procedures, one in five of those injuries permanent (2023 review); 8.4% of 545 procedures (2026 series) |
| Achilles repair; heel-bone fracture fixation | Sural nerve: outer edge of the foot and little toe | After 5.64% of percutaneous and 0.57% of mini-open Achilles repairs (2025 meta-analysis) |
| Ankle fracture fixation | Superficial peroneal nerve over the outer ankle: top of the foot | Pain with nerve-type features in 23% of those who answered a survey, 5.8 years on average after surgery; cause not confirmed (2017) |
| Morton’s neuroma removal | The cut end of the removed nerve (stump neuroma): ball of the foot | Reduced feeling after 48.5 to 62% of operations (2024 meta-analysis); only 74% pain-free afterward in a review of 35 studies (StatPearls, 2023) |
| Hammertoe and other toe operations | Digital nerves: the toe | Usually settles, occasionally permanent |
Tarsal tunnel release is an operation on a nerve itself, covered in tarsal tunnel surgery.
Sural nerve pain after surgery
The sural nerve runs down the back of the calf beside the Achilles tendon to the outer edge of the foot and the little toe. Achilles, peroneal tendon, outer ankle and heel-bone operations can injure it, as can taking a vein from the calf.
Sural nerve pain usually means numbness, tingling or burning along the outer edge of the foot, sometimes with a spot on the scar that zings toward the little toe when tapped. In a 2015 study of 17 skin nerves injured in foot and ankle surgery, 7 of them sural, most people regained feeling within six months. Sural nerve pain without an operation.
How long nerve damage takes to heal
A nerve block usually wears off within 4 to 24 hours. If its numbness lasts beyond 48 hours, the Royal College of Anaesthetists advises contacting your hospital.
A nerve that was only stretched or pressed, with its fibers intact, often recovers within days to weeks.
By now a more serious injury usually shows its extent. If a numb area has not begun to improve by three to four months, or pain is building, ask for a nerve assessment. A nerve cut right through cannot rejoin on its own.
Damaged fibers regrow about a millimeter a day, roughly an inch a month. In the 2015 study, feeling changed little between nine months and a year, and four people developed a painful neuroma at 9 to 12 months. After ankle arthroscopy, a 2026 series followed people with nerve symptoms for 13 months on average: 84.4 percent had improved, but only 44.4 percent had fully recovered.
What remains is more likely to be permanent, though pain can still be treated.
How nerve damage is diagnosed
- A sensory map. Testing light touch and pinprick outlines the numb area; its shape shows which nerve is involved.
- Tapping along the nerve. Tingling that shoots into the nerve’s patch of skin, a Tinel sign, marks the injured spot or a neuroma.
- A diagnostic injection. If local anesthetic beside the suspected nerve relieves the pain for a while, that nerve is the likely source.
- Ultrasound can show a neuroma and guide the injection. MRI helps when the diagnosis is unclear.
Nerve conduction studies measure only the large nerve fibers. The small fibers that carry burning pain are not tested, so a normal result does not rule out an injured skin nerve. What the test shows.
How to treat nerve pain after foot surgery
Many symptoms settle on their own. Meanwhile, check numb skin daily, and keep heating pads and ice packs off it. The daily foot check.
Once the wound has fully healed, usually by about four weeks, massage the scar with a plain moisturizer, then stroke it with textures from soft to rough, tap it lightly, or rest the foot in a bowl of rice. One NHS program suggests about 10 minutes, three or four times a day. A physical or occupational therapist can guide it, though research on it is limited.
Roomy shoes with adjustable laces or straps keep pressure off the sore spot. On healed skin, lidocaine 5% patches, capsaicin cream and clinic-applied capsaicin 8% patches are second-line options in 2025 international recommendations from NeuPSIG, a neuropathic pain expert group. Capsaicin cream stings at first; give it at least six weeks. Creams for nerve pain.
In the same 2025 recommendations, the first-line medicines are low-dose tricyclic antidepressants, SNRIs such as duloxetine, and gabapentin or pregabalin. Each has side effects, and in 2019 the FDA warned that gabapentin and pregabalin can cause serious breathing problems when combined with opioids or other sedating medicines, especially in older adults or people with lung disease. A local anesthetic injection, sometimes with a steroid, can calm a neuroma. How the medicines compare.
Freeing the nerve from scar (neurolysis), removing a neuroma and burying the nerve end in muscle or bone, repairing a cut nerve, or targeted muscle reinnervation, which joins the cut nerve to a motor nerve branch in a nearby muscle.
Evidence for these operations, including the newer ones, comes mostly from small case series, with no clear standard treatment. Ask what result to expect.
What to tell or ask your surgeon
Tell them where it is, when it started, whether it is spreading, what sets it off, and any change in skin color, temperature or sweating.
Before surgery, ask:
- Which skin nerves run near my incision, and what numbness should I expect?
- Will I have a nerve block, and whom do I call if numbness lasts past 48 hours?
- Should I stop smoking first? In the 2026 arthroscopy series, smoking was linked to more nerve complications.
More questions for any appointment.
Common questions
Is numbness after foot surgery normal?
Some is. A small numb patch beside the scar is common and usually improves over months, though a little may remain. Block numbness usually fades within 4 to 24 hours; call the hospital if it lasts beyond 48 hours. Spreading numbness or burning pain needs checking.
How long does nerve damage take to heal after foot surgery?
A nerve that was only stretched or pressed often recovers in days to weeks. Damaged fibers regrow about a millimeter a day, so deeper injuries take months; in one study, most people regained feeling within six months. No improvement by three months deserves an assessment.
What are the signs of nerve damage after bunion surgery?
Numbness, tingling or burning over the top and inner side of the big toe, a scar that tingles into the toe when tapped, and pain where the shoe presses. A 2026 review found altered sensation after 0 to 45 percent of open and 2.4 to 15 percent of percutaneous corrections.
Can nerve damage after foot surgery be permanent?
Sometimes. Most numbness improves, but some patches stay numb, and a painful neuroma can form months later. In a 2023 review of ankle arthroscopy, one in five nerve injuries was permanent. Lasting nerve pain can still be treated with desensitization, medicines, injections or surgery.
When should I call my surgeon about nerve pain after surgery?
Go to an emergency department for severe pain far worse than expected, especially with a tight, swollen foot or leg. Call at once about pale, blue or cold toes in a cast or dressing, or a foot you can’t lift; the same day for fever or spreading redness; as soon as possible for calf pain or swelling; and promptly for spreading numbness or burning pain. Call 911 for chest pain or sudden breathlessness.
Related reading
Nerve pain in the foot · Neuropathic pain · Tarsal tunnel surgery · Peroneal neuropathy
Sources and further reading: Bage T, Power DM, Iatrogenic peripheral nerve injury: a guide to management for the orthopaedic limb surgeon, EFORT Open Reviews, 2021. Nadi M, Dabbas W, Das JM, Peripheral nerve injury, StatPearls, 2026. Tang A, Bordoni B, Anatomy, bony pelvis and lower limb, foot nerves, StatPearls, 2023. Pont MP et al., Cutaneous sensory nerve injury during surgical approaches to the foot and ankle: a cadaveric anatomic study, Foot and Ankle Surgery, 2007. Chanzy P et al., Sensory nerves at risk during hallux valgus surgery: a systematic review, Foot & Ankle Orthopaedics, 2026. Arshad Z et al., Complications following ankle arthroscopy, Bone & Joint Journal, 2023. Roche D, Lopes R, Postoperative sensory nerve complications following ankle arthroscopy: incidence, risk factors, and clinical course in 545 consecutive procedures, Foot & Ankle International, 2026. Rodríguez-Merchán EC et al., Complications of ankle arthroscopy: frequency, prevention, and treatment, EFORT Open Reviews, 2024. Melinte MA et al., Mini-open versus percutaneous surgical repair for acute Achilles tendon rupture: a systematic review and meta-analysis, International Orthopaedics, 2025. Rbia N et al., High prevalence of chronic pain with neuropathic characteristics after open reduction and internal fixation of ankle fractures, Foot & Ankle International, 2017. Lee W et al., The comparison of postoperative outcomes in Morton’s neuroma excision between plantar versus dorsal approach, Foot and Ankle Surgery, 2024. Adán-Laguna J et al., Radiofrequency neurolysis versus surgical neurectomy for Morton’s neuroma, International Orthopaedics, 2026. Munir U, Tafti D, Morgan S, Morton neuroma, StatPearls, 2023. University Hospitals Coventry and Warwickshire NHS Trust, Lesser toe deformities, 2023. Royal National Orthopaedic Hospital, Bunion and lesser toe deformities, 2026, and Scar care after surgery, 2025. Kahn RL et al., The incidence of complications is low following foot and ankle surgery for which peripheral nerve blocks are used for postoperative pain management, HSS Journal, 2018. Royal College of Anaesthetists, Nerve damage after a peripheral nerve block, 2024. NHS Fife, Nerve blocks for leg, foot or ankle surgery, 2024. Bai L et al., Natural history of sensory nerve recovery after cutaneous nerve injury following foot and ankle surgery, Neural Regeneration Research, 2015. Charipova K et al., A comprehensive review and update of post-surgical cutaneous nerve entrapment, Current Pain and Headache Reports, 2021. Hendrickson NR et al., Treatment of postsurgical neuroma in foot and ankle surgery, Foot & Ankle Orthopaedics, 2018, republished 2023. Challoner T et al., Pathogenesis, clinical evaluation and non-surgical management of symptomatic neuromas, Journal of Musculoskeletal Surgery and Research, 2019. Cornacchini J et al., Update/refinement of targeted muscle reinnervation indication: a scoping review of applications for non-amputees, Journal of Clinical Medicine, 2024. Soliman N et al., Pharmacotherapy and non-invasive neuromodulation for neuropathic pain: a systematic review and meta-analysis, Lancet Neurology, 2025. International Association for the Study of Pain, Identifying neuropathic pain in the clinic, 2026. Eric H. Williams, MD, How foot surgery can lead to chronic pain, and how a peripheral nerve surgeon can help, 2022. Leeds Teaching Hospitals NHS Trust, Scar desensitisation, 2025. Cambridge University Hospitals, Scar massage information, 2023. Adler L, Bergman R, Kaiser K, Tarsal tunnel syndrome, StatPearls, 2026, on therapists’ role in preventing scar adhesions after nerve surgery. American Podiatric Medical Association, Neuromas. Lidocaine patch 5% prescribing information. FDA warning on breathing problems with gabapentin and pregabalin, 2019. The Dudley Group NHS Foundation Trust, Capsaicin cream, 2024. Warning signs: AAOS OrthoInfo, Compartment syndrome and Care of casts and splints; Washington University Orthopedics, Cast and splint care, 2017; MedlinePlus, surgical wound care, 2026; CDC, blood clots. On CRPS: NINDS, complex regional pain syndrome, 2026; Mayo Clinic, complex regional pain syndrome, 2022; Rewhorn MJ et al., Incidence of complex regional pain syndrome after foot and ankle surgery, Journal of Foot and Ankle Surgery, 2014; Teichmüller K et al., Incidence and treatment of complex regional pain syndrome after surgery: analysis of claims data from Germany, PAIN Reports, 2024.
This page is general education and is not a diagnosis, a treatment plan, or a substitute for care from your own clinician. Clinical review by Dr. Biernacki is pending; the review date will be shown here once complete.
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Dr. Tom Biernacki, DPM, FACFAS is a double board-certified foot and ankle surgeon (ABFAS and ABPM) and a Fellow of the American College of Foot & Ankle Surgeons. He is the founder of Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, where peripheral neuropathy, diabetic foot risk and loss of protective sensation are part of his weekly clinic. His patient education videos have drawn more than 950,000 subscribers on YouTube. Managing Neuropathy is written by its editorial team under his direction, to put the explanation he gives in the exam room in front of the people who cannot get to one — including when a product is worth buying and when it is not.