Night Pain: Using a knee wedge after total knee replacement?

@connie1559 - My Surgeon and PT emphasized no pillow under your knee. The last thing you get back is your extension and you can’t walk without pain if you don’t have your extension back. Wedge pillows with your foot on a roller and ice on top of that is one of the extension exercises - but you can’t rest your knee on the wedge. It’s for elevation over your heart and to reduce swelling only. They told me to Take some Benedryl to sleep.

@connie1559
I had my right hip replaced on 11/27/18 and have had continuing problems with sciatic nerve pain and weakened muscles in that leg which are now everyday problems. I had difficulty sleeping because of neuropathy which would start almost as soon as I was lying flat in bed. Just in the last two weeks I started using 2 pillows under my knees to relieve pressure on the lower back and that has helped a bit. Not sure if it would have been a good idea earlier but now at 9 weeks out it seems ok.

I used a pillow under the lower half of my leg, which is also what was done at the hospital. It helped with swelling and pain. I was also told not to put it under my knee. Maybe it has something to do with impeding circulation.

I, too, was told by nurses in hospital and PT people not to put a pillow under the knee. I is permissible to put a pillow lenghtwise under the leg to support it, and it is quite ok to put a pillow between the bent knees when you are lying sideways. Reason as stated above is to not hinder progress of extension.

Hi @connie1559 - I just had a left TKR on 1/29/19 (my right one was April 2017). Both times they were adamant about not putting any support under the knee - pillow, wedge, anything. The reason as @ellerbracke stated is extension - it is difficult to get the extension back and supporting the knee from underneath impedes the progress. I'm sorry to hear about the pain you are having. I wake up when its time for my pain medicine, but once I take it, I go back to sleep. Are you having trouble getting back to sleep after your meds?

I have had trouble sleeping since Day 1. I have a history of insomnia. For about the last 3 years I have been sleeping almost like a normal person. The surgery put a stop to that. Even the night after the surgery I was in too much pain to sleep.

I had my surgery done by a surgeon that came highly recommended. It was a wonderful hospital and the nursing staff couldn’t have been more kind, caring, efficient and attentive. I was walking 3 hours after my surgery, PT started the next morning, and was twice a day until I was discharged the morning of the 4th day. I have continued at home and will start formal PT on 2/11.

The first day after surgery, my pain was not well controlled. When my surgeon made rounds the second day I mentioned it. He made an adjustment and I had less pain. Of course some pain is to be expected.

At discharge, I was given a week’s supply of pain meds. They lasted through the 9th day, and I called for a refill.

I was shocked at the lecture I got from the doctor’s nurse about opioids and addiction. She said she would ask the doctor and call me back. She called on the 10th day to say he was authorizing a 5 day refill and that was the last refill.

I’m still having significant pain, especially at night. I’m also having a lot of thigh pain and swelling. Supposedly that is because of a tourniquet and is not uncommon. The thigh pain is worse than the knee pain, which is almost gone. Right or wrong, I have been trying to save some of the pain meds for PT. I have heard it can be quite painful.

I can remember prior hospitalizations and surgeries in the past 25 years. The theory about pain was “Pain never felt is pain never felt”. Not so these days. Now it feels more like “One opioid can cause addiction”. I think if I had better pain control at night I could sleep. I think lack of sleep has a cumulative negative effect on healing and progress. It’s a sign of the times.

I have heard good things about acupuncture. I think I may give that a try.

@connie1559 I’m sorry to hear about your pain. I know how difficult it makes it to sleep. The opioid crisis really has the doctors cracking down on prescribing much. On the plus side though I have read that ibuprofen works almost as well as prescription pain killers. Have you tried that? I can’t take any NSAIDs so was stuck with a limited amount of Tylenol which is not an anti-inflammatory and not much help.
I don’t know anyone who has had acupuncture for that type of pain but I do know people who have had great success with it for other things.
JK

I had a partial knee replacement 34 days ago. No on told me NOT to put a pillow under my knee. I have slept every night with one. I have 138 degree range of motion and a negative 3 degree of extension. The PT people are pretty amazed and my surgeon acts like it is normal. I just ordered a between the leg pillow to take the pressure off of my lower back where I have disk problems. Everyone is different. Good luck and speedy recovery.

I think the knee pain is normal considering the time frame since your surgery. I had pain while in the hospital 4 days and subsequently in a rehab facility. I was provided with narcotic pain killers. The pain eventually went away and my medications were changed to non narcotic. I also was instructed by the hospital not to place anything such as a knee wedge. Moving, bending your knee even though painful, using a CPM machine constantly, and aggressive physical therapy will eventually produce results. I did not receive the aggressive therapy that I should have had and also lost weeks of time in several instances by being discharged by the rehab facility, with the agreement that the insurance company was trying to find therapy for me in my area (lost an entire week and did not know at the time that this was the worst thing). By the time the at-home therapist came, he said I had absolutely no mobility and questioned as to what the rehab facility did. He worked with the surgeon to have me return to hospital for manipulation under anesthesia. Knee was manipulated to 120 degrees but a physical therapist in the hospital measured my flexion at 65 (which was better but not nearly 120 degrees). I was only in the hospital overnight. Subsequently went to outpatient physical therapy 6 days a week but that did not help either. Lost 3 weeks after the insurance company cut me off (did not know how seriously this affected my condition at the time). Returned to work and attended pretty aggressive physical therapy in Manhattan 3 nights a week but that did not help either.

I know there is an opioid crisis. I had opioids, without the restrictions that you are having (doesn't seem fair). Eventually I did feel that Ibuprofen was more effective as it relieves inflammation and at the later stages my pain was due more to inflammation than the initial surgery. However I was instructed to take the opioids particularly before therapy sessions. Eventually I was instructed to stop taking Ibuprofen too and prescribed a combination of other short term medics. I kind of recall having some thigh pain but that went away.