What pain is considered normal after TKR?

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11 days post RTKR and experiencing a lot of severe pain. Neuropathic pains at night are about a 10. The kneecap is super tender to touch and has sharp pains on moving. I'm taking the meds as prescribed but they barely keep the pain bearable and certainly not those at 3 am which are searing down the whole leg.

?Had physio today which seems to have made it all worse.

?Everyone I speak to seems to make more progress with less pain than me, although I know we cannot compare against others of course, I do wonder if my pain is to be expected or something to worry over? Today sat next to a guy who only took one dose of painkillers after surgery and has great results with his knee. I have been similar with other types of surgery so never expected to be so floored by TKR.

?Old knee very painful and limiting but at least I could manage the pain. I am going back to the GP to review the meds. The ones I have not strong enough really and making me drowsy with low BP and feeling faint, not something to be when on crutches.

?I know it can get better with time but do high levels of post op pain and neuro pain indicate something not going right (no signs of infection etc) or can these too resolve?

?It is hard to perform the excercises in this state causing concern about range of movement etc.

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  • Posted

    Oh Cynthia do I remember what you're going through. When I was in the hospital for 3 days after having bilateral TKR done my pain was controlled just fine, put in my IV and the nurses always checking on me. But when I got home I had to figure out what worked best. I came home with oxycodone and Tylenol and a muscle relaxant. I was told to alternate the oxycodone and Tylenol. The muscle relaxant didn't do anything so I stopped it. Soon the Tylenol wasn't agreeing with me and I just took the oxycodone around the clock with some sort of food. It sort of worked but I sure knew when it wore off because pain would wake me up. I had many hard to sleep nights but after about 2 weeks things calmed down. Thankfully, 9 weeks out and things are better but far from perfect! It's going to take time and patience. I am on Tramadol and ibuprofen 600 as needed now; usually Tramadol at night. Dear Lord, I hope you can get some pain relief. You need it to get any sleep possible!!! Prayers and luck to you.🙏??

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  • Posted

    Hi Cynthia,

    All I can go by is my own experience. I'm now 8 weeks today TKR and I can honestly say I didn't really start feeling much better until around 6 weeks. 

    Like you my pain was bad but bareable pre op and didn't expect the excruciating pain I had post op.

    I was on Tramadol & paracetamol four times a day and ibuprofen 3 times daily. I got off the Tramadol 2 weeks ago as it was making me feel dreadfully depressed and I couldn't cope with that. I'm happy to say that I'm almost off all meds now jut take paracetamol when I need it which on a good day is just before bed.

    The stiffness, swelling and heat is still there but less so now.

    After physio the pain is much worse so I make sure I take paracetamol an hour before I go.

    I think from what you've put it all seems totally normal. I remember saying a few weeks back on here that I wish I'd never had it done. 

    It does get better with time but no one other than TKR patients can even come close to imagining what sever pain it is. Every week it does seem to get better but this is a long slow painful recovery and I won't be hurrying into having my other knee done at any time soon.

    Re crutches, I used two until 2 weeks post op then went to one at about 5 weeks which my physio told me to do. I'm now in the last 2 weeks I'm walking crutch free even if I do look very ungainly 😬

    Hope you start feeling better soon which I know you will.

     

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    • Posted

      Oh and don't compare yourself with anyone else. This just adds to the frustration. You'll get there at your own pace when your body is ready.

      i hope you have a decent nights sleep as tiredness makes things seem ten times worse.

      big hugs 

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  • Posted

    Hi Cynthia, this is perfectly normal. I was the same after my knee replacement 2 years ago. Ask your doctor for stronger pain killers to help you get through through the next few weeks. Do your exercise after you have taken the pain relief. I used a children's skateboard to help me get the bend and stretch, it was a great tool to get me moving. Use ice after the exercises to help with the pain. It is a juggling act with the pain relief, I used to take paracetamol then two hours later the ibuprofen, keeping the good stuff for during the night. Just be careful not to over do it. It does get better.

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  • Posted

    Hi there Cynthia, welcome to the ever-changing world of Knee Replacements! First of all, you're only 11 days in - well done on being able to string sentences together! Coherent thoughts can be far and few between at this stage, what with extreme pain, sleep deprivation etc.....

    If I can put your mind to rest a little, everything you've described is totally normal and par for the course. TKR is said to be the most painful surgery that a person can go through, and I'm not about to argue with that! Don't try and compare your recovery with anyone else's, you'll invariably find yourself coming up short....and there are a few odd folks out there who can tend to - ahem - exaggerate their circumstances....I don't know why they do it......

    Anyway, severe night pain, Neuro pain, shooting pain, burning.....all part and parcel I'm afraid. But I agree that you should get your GP to review your pain meds, they have loads to choose from and sometimes it can take a while to get the combination right. Make sure you're getting plenty of rest, stay really well hydrated, and above all ice, ice, ice. Then ice some more! It helps more than I can say.

    Remember you're still in very early days and everything can seem new and scary, but we're always here, come and chat, rant, cry, do whatever - we know what you're going through!

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  • Posted

    First, you are very early in the recovery. I thought I was prepared for my TKR. Read and researched. My hospital even has a pre op class that was very informative. What I did not know was how excruciating and brutal the pain would be. My first two weeks of PT i cried from the pain. Take pain meds a half hour before your PT. Pain management is vital. Your symptoms are similar to most of us. You do need to speak with your doctor about dosage and strength. When I started my recovery, I changed meds three times. I am now 13 weeks post op and am basically pain free during the day. At night is another story. If I am walking a lot or on my feet too much, the knee throbs. I do still take prescription drugs at night. I found a "knee" pillow on Amazon. Best thing since sliced bread. Search for it on Amazon. Also bio-freeze and vitamin E cream. It will get better. For me it was 6 weeks when I finally started to feel better. Stay in touch with this forum. Our leader, Chico Marx, has fantastic knowledge and will be a major resource for you. He will read this and give you the links. Just remember, it gets better. In the meantime, read a trashy novel and eat blueberry muffins.

    Ellen

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  • Posted

    Hi Cynthia I'm nearly 3 weeks post op and still in pain the 1st week I was waking up every 2 hours at night and wished I'd never had the surgery 2nd week I went to my GP and asked for a stronger pain killer he gave me co codamol but the strongest I was also taken morphine what the hospital had given me but had to stop taking that as I was so ill with it. I'm also worse after exercise it's so painful. But trust me it does get better into my 3rd week now and every day I'm improving so much and even forgetting to take my pain killers on time I'm finally walking without my crutches except if I'm going upstairs or in the garden keep your chin up things can only get better I'm still getting lots of advice on here of people. Good luck take care

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  • Posted

    Hi Cynthia I am Day 17 post op. I was discharged home on morphine for first 9 days. Now take co codamol, naproxen and I could probably reduce dose as more dull ache. Had staples out yesterday n all going ok but knee not strengthening v well. Consultant advised hanging a bag with tins from my calf n thigh whilst leg on coffee table, so that's my new exercise. I haven't started physio yet- Friday. In doors I don't use crutches but not confident outdoor so still use two.

    On day 7 the pain was so bad at night I thought I needed to go to A&e however I found this site which really helped and reassured me. Night remain terrible can never get comfortable and I think 7 hours sleep will never happen again. So as everyone else says hang in there and this is such a supportive site.

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  • Posted

    Every night my husband would put a towel around my knee and pack ice around it. All through the night he'd repack with fresh ice. This allowed me to sleep for about three hours at a time with minimal pain. I take Tramadol and a muscle relaxant. Guess Tramadol doesn't work on everyone. When I'm sitting or laying down I have ice on me.

    Hope you can find something to get much needed sleep. Take care. I'm at 5 weeks and it will get better. They say this is a year long recovery so we have 11 months to go😄

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    • Posted

      My instructions from the hospital said 10 minutes of every hour, but I'm using  a cryo pack which isn't quite as cold as ice and moving it round to different bits of the knee for twenty minutes at a time.  I never put it over the scar though until it was properly healed.  Same as heat - I avoided the scar and still do.

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    • Posted

      Hi Suzie, ah that's SO interesting about not using ice too much. Amazing nobody tells you. My surgeon just said ice ice ice.so I have . I think I may be over doing it. Thanks for that tip I will now try 2-3 times a day. I was doing it nearly every hour day & night.

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  • Posted

    I feel for you, but thought I would give you an excerpt from my diary at 6 weeks PO

    Had private physio she freed my muscles by massaged gently around the knee and scar, helped take the swelling down but the top stich area became a bit inflamed, think it is where the crap is being released from scar area. Managed to get time to about a 125% bend, felt shaky after but found I could actually walk properly, found a big difference and now not walking flat footed. Felt much more up beet, felt I had turned the corner at long last. Just sleeping with flatish pillow under let or between legs defo much more comfortable. 

    At 20 weeks I was back playing lawn bowls.

    I am about 14 months PO now and so glad I had it done !!

    My other knee is getting slowly worse. Advised by physio, not to have other knee done unless pain gets to same level as the other one did, and continually locking out, can’t sleep and unbearable to walk far. As there is no guarantee the 2nd knee will go as well as first.

    Hope this helps some of you along your journey, stay positive you will feel so much better soon, just do the excersises they are very important and when swolen elevate and ice, and take your meds smile

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  • Posted

    Do not worry Cynthia, if you watched the operation performed on YouTube you would understand why you're in such pain! Your knee has been butchered! Sliced & diced! You've had your bones cut away & a metal spikes hammered into them! No wonder you're in pain!

    Maybe the pain is neural, nerves cut in the op repairing themselves as well as muscle, so do see your GP & ask for better pain relief. You need good pain relief to exercise efficiently & to be able to relax to go to sleep. Unfortunately sleep is one of the things that suffers after TKR!

    I agree with you that this is a hard op to recover from, I had, since 2013, 3 Eye ops,2 Thyroid ops (hemi then completion thyroidectomy) & recovered from all of them easily. TKR is tough! Tough on you, tough on your nearest & dearest!! In the early weeks it is unrelenting! You will get there. One day you'll wake & think wow I actually slept for a few hours. You will notice the pain is diminished & one day gone! It won't happen over night I'm sorry to say, but it will happen! You will realise you are walking without difficulty or pain. It will creep up on you rather than here today gone tomorrow!

    Keep your sense of humour, ice, elevate, exercise & rest. Massage your knee well with BioOil or similar, warm the joint before you exercise it all helps.

    Given time you will gradually feel the benefit of your TKR. At the moment all you feel is down! Chin up, we can get through this together. With all of us on here.

    Take care

    Marilyn

    XX

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