How well is pain controlled after total knee replacement?

Posted by connie1559 @connie1559, Jan 12, 2019

I'm scheduled for a right TKR on 1/21/19.

I own my own small business, and I'm the only one who does the accounting and other functions for a busy retail store.

I will have the surgery on Monday, 1/21, and barring unforeseen problems, will be released from the hospital on either 1/23 or 1/24/19.

I have deadlines on several things for my small business, including getting out W-2s, 1099s, CDTFA payments,and customer store charge account statements, as well as the renewal of my business's liability and work comp insurance. In addition, I will have to do payroll for my employees. I will probably have to work in my office several days between 1/25 and 1/31. I will be having PT appointments as well during that time.

I currently have a pain contract with my GP. I live in a rural area, so my GP is familiar with my ortho and his pain control protocol. My ortho will be handling my pain control, rather than my GP, for a period of time during the TKR process. My GP told me that the ortho will send me home with a few days supply of pain meds and then will "drop the ball on refills". Also, it is my understanding that no refills will be given without an office visit. It is a 3 hour round trip for me to visit my ortho or GP.

I have seen discussions in this joint replacement group when some post TKR patients have said they have extreme pain, and others have said the pain was not as severe as might be expected.

Is it realistic of me to expect that my pain will be well controlled with just OTC products and icing and elevation? I know that most TKR people have said that it's a good idea to stay ahead of the pain before PT with proper use of pain meds to maximize the benefit of PT. I have also seen a lot of posts where people have said the pain impacts their ability to sleep. If I'm going to heal, go to work, and get the most benefit I can out of PT, I'm afraid my pain will be pretty bad if my ortho is lax about refills.

Has anyone had experience with having to carry on a busy schedule after TKR, including the necessary amount of PT, without benefit of prescription pain meds? Am I fretting over nothing? Thanks so much for any answers. Good luck to all of us!

Interested in more discussions like this? Go to the Joint Replacements Support Group.

I had my knees replaced 3 months apart. I was shocked at how very different my pain level was with each. Totally different. I had NO post surgical pain with the first one. I never even felt a thing when the blocks wore off. I stayed ahead of expected pain with Tramadol, but soon realized I didn't need. Tolerable pain with rehab exercise and movement. I do have a high pain tolerance. Second knee I took almost entire Rx of 30 narcotic and was so glad I had it at the ready. Severe pain for first week or so and it took me about twice as long to rehab as the first. It is now at 4 months post surg and I have turned the corner. Pain not problem, but stiffness persists that I did not have with first knee. I am now strong enough to walk thru the stiffness without limping, which was my main problem. I was very dedicated to my rehab and did an hour at the PT gym everyday for three months with both surgeries.

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@u13496

I had my knees replaced 3 months apart. I was shocked at how very different my pain level was with each. Totally different. I had NO post surgical pain with the first one. I never even felt a thing when the blocks wore off. I stayed ahead of expected pain with Tramadol, but soon realized I didn't need. Tolerable pain with rehab exercise and movement. I do have a high pain tolerance. Second knee I took almost entire Rx of 30 narcotic and was so glad I had it at the ready. Severe pain for first week or so and it took me about twice as long to rehab as the first. It is now at 4 months post surg and I have turned the corner. Pain not problem, but stiffness persists that I did not have with first knee. I am now strong enough to walk thru the stiffness without limping, which was my main problem. I was very dedicated to my rehab and did an hour at the PT gym everyday for three months with both surgeries.

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@u13496 : I found you post interesting - especiallly regarding NO pain with one of your TKR’s. I thought it was an urban legend..... although I heard about a friend of a friend who was in her mid 70’s, overweight, couch potato, who also never experienced any pain. Life is unfair, seemingly! I’ve been active all my life, slightly below normal weight, and boy, did the knee hurt after surgery!
I’ve been following the various issues regarding knee replacements, and I seem to be the only one (at least the only one mentioning it) that has the clicking sound and feeling in the knee. Not painful, but to me a constant psychological reminder that it’s not my own. Even now after 5 months, when it feels pretty natural, you can hear me coming when the room is totally quiet. Anybody know how common it is, and if or when it ever diminishes? Granted, I take this over problems with ROM, pain, or scar tissue, but it would be nice not to have it.

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@ellerbracke

@u13496 : I found you post interesting - especiallly regarding NO pain with one of your TKR’s. I thought it was an urban legend..... although I heard about a friend of a friend who was in her mid 70’s, overweight, couch potato, who also never experienced any pain. Life is unfair, seemingly! I’ve been active all my life, slightly below normal weight, and boy, did the knee hurt after surgery!
I’ve been following the various issues regarding knee replacements, and I seem to be the only one (at least the only one mentioning it) that has the clicking sound and feeling in the knee. Not painful, but to me a constant psychological reminder that it’s not my own. Even now after 5 months, when it feels pretty natural, you can hear me coming when the room is totally quiet. Anybody know how common it is, and if or when it ever diminishes? Granted, I take this over problems with ROM, pain, or scar tissue, but it would be nice not to have it.

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@ellerbracke I also have clicking with my new (5 yrs) knee. At one of my earliest appt’s following surgery, he showed me how my knee would click sometimes and that it was normal. It doesn’t click all of the time, only when I move certain ways so doesn’t bother me.

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@ellerbracke

@u13496 : I found you post interesting - especiallly regarding NO pain with one of your TKR’s. I thought it was an urban legend..... although I heard about a friend of a friend who was in her mid 70’s, overweight, couch potato, who also never experienced any pain. Life is unfair, seemingly! I’ve been active all my life, slightly below normal weight, and boy, did the knee hurt after surgery!
I’ve been following the various issues regarding knee replacements, and I seem to be the only one (at least the only one mentioning it) that has the clicking sound and feeling in the knee. Not painful, but to me a constant psychological reminder that it’s not my own. Even now after 5 months, when it feels pretty natural, you can hear me coming when the room is totally quiet. Anybody know how common it is, and if or when it ever diminishes? Granted, I take this over problems with ROM, pain, or scar tissue, but it would be nice not to have it.

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@ellerbracke I knew a man whose hip clicked. The manufacturer did a recall on that hip for that reason. He did not opt to have that, he felt the clicking was more tolerable than having a new hip again.
JK

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@cmael

@ellerbracke I also have clicking with my new (5 yrs) knee. At one of my earliest appt’s following surgery, he showed me how my knee would click sometimes and that it was normal. It doesn’t click all of the time, only when I move certain ways so doesn’t bother me.

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Lucky you.... it does click every time I move the knee, whether I put weight on it - as in walking - or not, as in moving the knee during floor exercises. Annoying! Only time I don’t hear/feel it is when swimming......well, not with backstroke. Breaststroke it still clicks. And deep squats are quiet as well. Go figure........

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@bobnaquin

I did the same thing and had the same problem. I think we have all been brain washed into thinking if we take prescription pain meds we going to end up being junkies. I am calling BS on that. I set myself back and wish I had not done it. The chances of me getting hooked on prescription pain meds is close to zero as I don't get much out of them including pain relief. I think you have discovered that you should do what your doctor thinks best about pain meds and hopefully it will make you better sooner.

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Thank you so much for your comment. I had my TKR on 2/7 and my PT and friends are already on me about being off the narcotics. This is the most severe pain I've had in my life and around day 5, I listened to them and cut back. Don't! I paid for 24 hours trying to get the pain level back again. Talk to your doctor, listen to your own body, and trust the direction on the prescription bottle. When your own reduced pain experience happens, go off the pills. So much pressure when you're already in so much pain.

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