Average level of pain after TKR?

Posted by ellerbracke @ellerbracke, Mar 17, 2019

I had right knee TKR 6 months ago. Perfect ROM and extension (after hard work), functioning very well. However, I am fluctuating between what I would call “awareness” of the artificial joint - just a little sore - to aching, to moderate pain. Depends a little on activity level, weather, who knows, but it is always present, and I resent it. Some (many?) people are pain free at this stage. Should I be concerned, or will the magical 1-year mark fix this?

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Hi @ellerbracke that sounds very frustrating to continue to have so much pain.

I wanted to tag fellow Connect members @babette @sraley1 and @contentandwell as they all have had TKR's and may be able to offer you their experience with pain around the 1 year mark or approaching that mark.

Back to you @ellerbracke what has your doctor or physical therapist said about your pain?

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@ellerbrake Hi - I'm sorry you have having pain at 6 months out. I'm almost 8 months out and have pain, too. My surgeon really isn't very helpful. I've said before that surgeons seem to have all the answers pre-op and during the operation but no answers after! Mine relies on PT to continue the process and my first PT was awful (another story). I was so frustrated with 1) pain, 2) inability to go up and down stairs properly at this stage and 3) being unable to stand from sitting without an armchair, that I sought a second opinion with a big-deal surgeon in Boston. He put me on an at home protocol of riding a stationary bike and doing exercises and things improved ... for a time.

I'm going to see a new PT recommended to my by a good friend. I just need to get some perspective re: where I should be at this stage and who she thinks are the best area surgeons, as I have to have my second knee done. Maybe you can find someone to consult re: this perspective. I wish you good luck and healing.

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Hi @ellerbracke - Thank you for posting this. You gave voice to a conversation I've been having in my head all week. Tuesday I will be 7 weeks out from a TKR I had on Jan 29. I got off the oxycodone at 5 weeks. I did this by doing acupuncture twice a week and using CBD oil topically and internally daily. I think both helped, but I still couldn't go "cold turkey". I switched from oxycodone to Tramadol - which I understand is much safer and not addictive. I take two a day. In the morning - especially before PT - and at night before bed. The Tramadol is not as strong as the oxycodone, but much better than Tylenol XS - which does nothing for me. Friday I called the doctor to get a refill and they gave me enough for 1 week - 14 pills. Really? I guess they think I am ready to be off all pain meds. I know I've heard of people who don't take anything after a few weeks, but truthfully, I have done everything in my power to wean off of drugs and I still need them. I love how you say you resent the pain. I resent it too - AND I resent the whole system that makes it so hard to get pain meds for a REAL need. I did not get addicted after my first TKR, and I'm being responsible about meds this time too.

Are you taking anything at all to take the edge off the discomfort/pain? I cannot wait to hear the answer to whether the one year mark is the Holy Grail!!

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My advice to anyone getting a TKR is to get on pain management and make arrangements for pain meds for as long as you need them. I am 7 weeks PO and am still on Hydrocodone and I couldn't be doing my PT without it. Please bear in mind that I am not breezing through this surgery like some people. I'm struggling to a 110 ROM. It's awful and I NEED the pain meds. I"m smart enough to wean myself off when the time is right and so you are and most other people who get TKR.

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@ellerbracke @ethanmcconkey I doubt that anyone with a TKR is ever completely without some occasional sensation of pain or discomfort, but I don't think the level of pain should be substantial at one year. My right knee, which I had done about five or six years ago, does hurt a bit after exercise but not so much that it really intrudes on my consciousness. My left knee, done in October 2017, hardly ever hurts. I would have said never but I apparently exercised more than usual at the end of last week and both knees were hurting and my quadriceps were killing me. That was pretty much the first time in a very long time that I actually took a Tylenol for something.
This may sound odd, but I'm beginning to think that perhaps I don't feel pain as acutely as most people do because other than the migraines I used to get, I have not been very bothered by pain anywhere. The level of pain I sometimes feel is more what I would consider mild discomfort. and believe me, it is not that I am a stalwart person.

@dkapustin That all being said, I was in really bad pain for about six or 7 weeks after my last TKR, so much so that my surgeon was seeing me regularly to see how I was doing. He was concerned. Thankfully it suddenly lifted and I have done great since then.
JK

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I too have pain at 11 months following my TKR....

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To all who weighed in so far: Therapist says to be patient, and don’t overdo it like I tend to do. However, there’s no rhyme or reason for when and how intense the pain will be. Last week Monday I worked in my raspberry patch for 1 3/4 hours (pretty strenuous), after my usual daily 20 minute morning exercises and a 30 minute session in the pool. Tuesday 2 mile walk, then I helped a neighbor dig up some shrubs, Wednesday pool again, and I did some more yard work and dug a short trench to put a drainage pipe in - and I felt very good. Thursday not much of anything, and the knee was ornery. As I said, I can’t predict what’s going to happen. Taking the occasional Aleve, but have not done so in about 3 weeks. Currently I’m dosing myself with MSM powder on the advice of my bother, who went through knee issues recently. Seems to help lull the pain, and supposedly has no side effects. I would not mind some aches or slight pain once in a while, if I had absolutely perfect days in between. It’s the constant, very often very mild, and only part of the day, but ever present twinges and from time to time real bone-deep aches that get to me.

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@ellerbracke

To all who weighed in so far: Therapist says to be patient, and don’t overdo it like I tend to do. However, there’s no rhyme or reason for when and how intense the pain will be. Last week Monday I worked in my raspberry patch for 1 3/4 hours (pretty strenuous), after my usual daily 20 minute morning exercises and a 30 minute session in the pool. Tuesday 2 mile walk, then I helped a neighbor dig up some shrubs, Wednesday pool again, and I did some more yard work and dug a short trench to put a drainage pipe in - and I felt very good. Thursday not much of anything, and the knee was ornery. As I said, I can’t predict what’s going to happen. Taking the occasional Aleve, but have not done so in about 3 weeks. Currently I’m dosing myself with MSM powder on the advice of my bother, who went through knee issues recently. Seems to help lull the pain, and supposedly has no side effects. I would not mind some aches or slight pain once in a while, if I had absolutely perfect days in between. It’s the constant, very often very mild, and only part of the day, but ever present twinges and from time to time real bone-deep aches that get to me.

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@ellerbracke Oh my goodness, no wonder you are feeling pain! You really are doing a lot. Listen to your therapist -- be patient and DON'T overdo!
JK

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@ellerbracke

To all who weighed in so far: Therapist says to be patient, and don’t overdo it like I tend to do. However, there’s no rhyme or reason for when and how intense the pain will be. Last week Monday I worked in my raspberry patch for 1 3/4 hours (pretty strenuous), after my usual daily 20 minute morning exercises and a 30 minute session in the pool. Tuesday 2 mile walk, then I helped a neighbor dig up some shrubs, Wednesday pool again, and I did some more yard work and dug a short trench to put a drainage pipe in - and I felt very good. Thursday not much of anything, and the knee was ornery. As I said, I can’t predict what’s going to happen. Taking the occasional Aleve, but have not done so in about 3 weeks. Currently I’m dosing myself with MSM powder on the advice of my bother, who went through knee issues recently. Seems to help lull the pain, and supposedly has no side effects. I would not mind some aches or slight pain once in a while, if I had absolutely perfect days in between. It’s the constant, very often very mild, and only part of the day, but ever present twinges and from time to time real bone-deep aches that get to me.

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Wanted to add here: between onset of knee pain, and initial unhelpful knee scope, and TKR, those varying degrees of twinges, discomfort, pain, and intense pain have been going on since August of 2017 - that’s why I’m so tired of and perhaps super sensitive to them.

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@ellerbracke I am 10 months out of my TKR and the nerves are still healing, which I am told is normal. My knee gets stiff. I also need to have my let knee replaced which has thrown my gait off and I have all sorts of aches and pains. Compared to the pain during recovery, this is tolerable. I do want to quote my PT. I was talking about being stiff one day this past winter and he said "You are now a walking barometer." The new knee will never feel like the original knee when it was at it's prime, but I can tell a difference in the stability. After falling more times than I can count in the past few years, I just want to be stable on my feet. Falling after 30 hurts a lot more! 😀 It has changed my lifestyle quite a bit. I used to be on my feet at work all day going top speed, non-stop. I am no longer able to do that. I have had to slow down my pace.

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