Sudden onset of 9-10 level pain 1 month post TKR

4 weeks is still very early days. Quarter of a mile doesn't sound like a lot but so soon after tkr it could just be a bit too much for your knee. Have you been out walking before this, or just walking round house and garden? Healing is a very long, slow and arduous process, with some good days, some bad days, You should still be icing your knee for 20-30 minutes every 2-3 hours. Allow yourself a pain killer or two - whatever works for you. Maybe gently massage with Voltaren gel (diclofenac). And rest. At this stage, while exercises as per your physiotherapist are crucial, don't overdo - you won't get there any quicker, quite the contrary. And rest. Be kind to yourself. I hope tomorrow, if not later today, you will feel better.

It could be many things, but sounds like it might be the nerves reconnecting. Was it like someone putting hot needles into your knee? I had terrible pain very suddenly at 4 weeks, right through the centre of my knee cap after doing a new exercise. It took 2 weeks to settle down. You will find all sorts of pain in this long recovery, but if it doesn't clear up after a while, or you're worried, see your surgeon. I hope it settles soon.

This recovery typically takes a full year with advances, setbacks and plateaus. It is NOT linear. Post this on your fridge...

Reality

Cruising? Remember to bring your oars for the boat part...

i discovered those are called zingers, zaps!! the nerves are coming alive and repairing itself!! thats a good thing!! google it

At my 6 week post surgery mark, I had been recovering very well (or so I thought) until I experienced sudden, sharp pain on the lateral side of my knee when I was out on a walk. The pain continued with almost every step until I made it back home. Once I was able to sit and elevate/ice my leg, the pain subsided. However, it continued to happen anytime that I put too much pressure on my leg and/or when I moved my leg in a specific way (usually a twist or bend of any kind). The pain was sharp and would often cause me to gasp audibly. My PT sessions were changed to passive activities such as ice and iontophoresis patches, but NO exercises for three weeks until the movement related pain began to subside. At that point, my PT slowly started to add exercises back into my sessions, starting back to light stationary cycle, light banded exercises, short walking and a return to range of motion stretches. In that 4 week period of time where I had ceased most activity, I basically lost all of my gains from my first 6 weeks of rehab, including my range of motion. The PT and my surgeon indicated that I had likely pushed myself too hard and had probably irritated my IT band or my bursa and that I needed to give myself a rest for any soft tissue irritation to resolve. They did not feel that my issues were nerve related since the pain predictably occurred upon specific types of movement. Other than foam rolling the IT band, I faithfully rested as advised.

The bottom line for me - and as others on this forum have said - it is possible to overdo the rehab, and the result of that can cause delays in your overall recovery. I thought because I was so fit before the surgery, that I could be the superhuman who recovered quickly, but as I found out in a terrible way, we just need to go easy on ourselves and make peace with the fact that our knees are calling the shots and we need to listen. That said, it does get better and at 6 months post surgery, that sudden pain I experienced at week 6 is now fully gone. I'm certainly not back to my pre-surgery activity levels, but because of the support on this forum, I now realize that it will be a year or more before I will feel almost normal again. Best wishes in your recovery!