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TKR pain worse at night

Posted , 23 users are following.

Lywn
Lywn

Why does my TKR pain hurt so much worse at night than during the day? 12 days post op. 

0 likes, 60 replies

60 Replies

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  • dee38339
    dee38339 Lywn

    Posted

    Hi I was told not to elevate the knee too but I did in bed at night for comfort and found that as long as I exercised and used ice it is fine. I am 9 months post op with right knee and 14wks post op with left knee, and am back on exercise bike after 18months and walk without a limp for first time in 20 years whatever works for you is good but make sure you keep bending that knee.
    • Lywn
      Lywn dee38339

      Posted

      Dee,

      That is a lot of surgery.  It is good to hear you are walking without a limp.  Many years ago I was in a car wreck that didn't seem very serious at the time.  My knee has hurt since then, though.  It finally deteriorated to the place something had to be done.  I'll try my best to bend the knee.  I hope you continue to improve.  Thanks for the encouragement.  

       

    • jenny80029
      jenny80029 dee38339

      Posted

      Did they say why you should not elevate the knee? It seems odd! I am seven months post op now! It's great! I had a limp just for around a year, and it is amazing not to have it anymore! I still get a thrill walking out the door with no stick! Good healing to you!

  • cynthia89958
    cynthia89958 Lywn

    Posted

    I think the theories are true, that we stay still and stiffen up at night, also our blood vessels change as when from standing and this increases pain response, along with hormones and body functions being different at night time. Pain of any kind often worsens at night and we are less tolerant, being tired and desperate for sleep and not otherwise distracted. I found cold gel packs around the knee helpful but we need to be careful not to have them on too long or when / if we nod off as told to limit use to about 20 minutes and wrap them in something so as not directly on skin. My gel packs used to lose their coldness in about 20 mins so I felt they were fairly safe and reduced the pain. I was not good with pain meds so relied on these gel packs, always had them chilled ready.

    ​I also found that raising the bedcovers off the legs helped me - bought an inexpensive bed cage on line so duvet was kept raised but I was not uncovered, as the gel packs made me feel a bit cold generally sometimes.

    ​I also bought a smaller TV for the room so if sleepless, at least I could be distracted from the pain and worrying about it all. I had not the energy to read!

    ​In time, we do find pain becomes more manageable and sleeping becomes less of a problem, but it is difficult at first for many of us TKR folk.

     

  • MSBCMB
    MSBCMB Lywn

    Posted

    Lywn

    Very early days yet ask your Dcotor if he can prescribe you some Oramorph that will help a lot ok

    Hi into my 13th week TKR 12/7 2007 very stiff in mornings normal totaly of Meds except for over the counter cocodamol and paracetamol all in all ok 105 degrees but after standing to long 3 hrs so starts to get painfull lots of Support from a loving Wife was a tower of strengh for me personaly

  • jenny61596
    jenny61596 Lywn

    Posted

    Hi , I’m 9 days post op and yes night is worse . I get two hours sleep at a go if I’m lucky , usually less I have to say . I just don’t try and go back to sleep , I get a cold pack , make a hot drink , turn on Netflix and take an OxyContin or whatever . Then just wait unlit I feel like dozing off . The night pain will be the last thing to go I imagine , gets stiff and swollen . I had glue so I think this may have helped because I can sort of sleep a while on my side . I’m just can’t lift my leg yet or get enough bend , got 120 in hospital on machine but once out couldn’t the swelling also seemed to hinder it . Just have to slowly persevere now I’m over the worst . I think also different surgeons do things slightly different . I never had a drain in like some I see . Anyway I hope things can only improve . At night just don’t stress , take pains meds , plenty of time to sleep during the day
    • sarah87162
      sarah87162 jenny61596

      Posted

      See my post above 3 months ago. Hang in there this is still very early days, it does get better.

      Take care and keep in touch

      Sarah xx

    • jenny61596
      jenny61596 CHICO_MARX

      Posted

      Thanks will have a look through . I am a bit concerned I can’t lift my leg yet , my muscles just seem to be not activating , also the bend isn’t enough . By 2 weeks pst op is this a major problem? Trouble is I do exercises to try and bend and lift in morning this then causes swelling to any others for rest of day are hopeless because swelling and pain ! Just kept trying , not improving yet though ! Thanks for you advise 
    • CHICO_MARX
      CHICO_MARX jenny61596

      Posted

      At two weeks, I was still drooling on my pajamas...  I started PT at 3 weeks...measured -14 / +84.  After 10 weeks @ 2X/week plus the work at home, I was -1 / +123.  At two weeks you haven't even started yet...  You have scar tissue building up that has to be broken down, swelling that has to subside, pain that has to be reduced, and much more.  This is a process...a looooong process.  

      Give up all your expectations regarding time...your knee will be healed when it is healed.  No one knows in advance how long their recovery will take.  We all counsel to think in terms of a one year recovery.  Things tend to progress in approximately three-month stages:

      1. @ 3 Months: The worst pain is gone, some residual minor pain remains, ROM is achieved, PT is finished, walking aids are discarded.

      2. @ 6 Months: Back to work, walking is fairly normal, virtually all pain is gone, swelling is way down, you have started the exercise program to rebuild your muscle strength, still feel some tightness.

      3. @ 9 Months: Your dead quads, glutes and core should be almost back to normal, you are starting to feel like your old self again, activity increases, stairs start to become less problematic.

      4. @ 12 Months: You throw a BIG anniversary party, swelling is gone, you've mastered stairs again (up and down alternately without holding onto anything), you don't even think about the knee any more.

      5. Beyond One Year: Some people report minor swelling episodes, some stiffness when they sit too long, residual tightness, incision site numbness, clicking and clunking sounds, nerve issues when kneeling, etc.  Most of this resolves in the 12-18 month time frame.  Some minor residual site numbness is probably permanent; nerve issues when kneeling could persist for a long time.

      This is a HUGE generalization as everyone experiences this recovery differently.  After reading thousands of posts, this seems to be a fair representation of it but you cannot use it as a definitive timeline.  There is no definitive timeline on an individual basis.  A year from now, you'll look back and see how you did in relation to this and find that you may have been a bit ahead of or behind the "average".  No way to predict it now.

      So...  Do the work, give it time and have patience.  And stop worrying!!!  You will be better when you're better.  STAY STRONG!!!  Own your recovery!  There is no such thing as "hopeless"...

      https://patient.info/forums/discuss/tkr-and-post-operative-depression-604195

      https://patient.info/forums/discuss/tkr-and-ptsd-569521

      https://patient.info/forums/discuss/the-reality-of-a-tkr-recovery-in-one-picture-626038

      Hope these help...

    • jenny61596
      jenny61596 CHICO_MARX

      Posted

      Thank you so much for your advice and time . I will stop worrying and taking too much notice of what the physio said  I should be capable of. Not realistic I think . 
  • stacey160465
    stacey160465 Lywn

    Posted

    Hello looking for some advice. I had a partial knee replacement in Dec 2016 on my right knee then a full knee replacement in Nov 2017 on my left knee. The pain from the tkr is at times unbearable. I've had to return to work as a teacher which is ok but the swelling and pain has me in tears at the end of the day. Pain killers don't seem to help apart from bung me up. I'm afraid of becoming addicted to the co-codamol which I'm prescribed. I'm feeling very vulnerable and sad

    • jenny61596
      jenny61596 stacey160465

      Posted

      I had one Dec 19 the first 7 weeks were hell , I didn’t go to rehab because closed over Xmas , pain killers helped and lyrica for nerve pain , now it’s mid March , stopped all opioid pain killers two weeks ago , had a week of withdrawal symptoms so was silly of me . Pain now a dull ache , still worse at night . Never had a lot of swelling . I didn’t do what all the physics said , ie push it , but my bend etc is fine , been doing water aerobics Dow two weeks , I think it varies a lot how people cope . I still feel tired and I’m not working so no surprise you feel like you do . It’s a very debilitating op , painful and invasive , I still have nerve pain but just found meds didn’t agree with me . Just time is the thing , and bending and stretching . I was told vit B helps nerve pain , not sure . I think also it makes you depressed and I had high anxiety , also felt like crying for no reason . So think what you feel isn’t unusual , it’s just time with this op . Good luck 
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