Debilitating pain 6 months after knee replacement

Posted by canls @canls, Apr 21, 2019

My husband had knee replacement surgery six months ago. The knee is still swollen, hard, and very warm. He still has chronic pain. He's at a constant 3-4 level most of the time, with episodes that shoot the pain up to 9 -10 range every day -- every damned day! -- that bring him to tears. And this is a man who's had broken bones, suffered concussion, and had a total hip replacement and was back on the golf course in six weeks. He's had every blood test you can think of to rule out infection. He's been X-rayed and scanned to rule out anything else. And we're told everything with the new joint looks fine, so keep doing what you're doing and it will get better. He does PT. He elevates, He ices. He does deep breathing. We've been to a pain management specialist who's fiddled with his meds and done laser therapy. And nothing works to bring the pain down. it's not getting better. Any ideas or recommendations?

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

If anyone has bad IT band syndrome ask your PT for cupping. it's like a complete turnaround!! The cupping separates the fascia from adhering to the muscle underneath. It's a great tool!

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Hi @lindalockie that must be awful having so much pain and not being able to take most painkillers.

I wanted to introduce you to @debbraw @ellerbracke @johnbishop @babette @sraley1 and @contentandwell as they all have had TKR's and may be able to offer you their experience with pain.

Back to you @lindalockie what have your doctors or physical therapists said about your pain?

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@lindalockie

Hi after a right total knee replacement 6 weeks ago and problems finding I was allergic to all heavy duty painkillers so could only take paracetamol I now still have extremely unpleasant burning pain down my inner thigh back of calf and into my foot Could it be a result of tourniquet?
Finding rehab on my knee very difficult

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Hi @lindalockie, You mentioned a tourniquet. Was one used during the surgery? I'm in week 3 post op and my care team has told me that controlling the pain was job one and rehab exercises job two. Are you able to discuss your pain with the doctor?

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@canis I'm so sorry to hear about your situation but I am right there with your husband. I'm 9 months out and while my gait is good, I have lots of pain in my surgery knee (and other knee: bone on bone). It is miserable and so frustrating! I struggle mostly with walking any distance and climbing stairs (going up is improving, but down is still the step-together-step method). My surgeon thinks all is fine (based on his exam and X-rays) and I've seen another surgeon for an opinion and consult for the knee that need to be done next. One thing you should know is that most second-opinion surgeons will not comment on your TKR until you are a year out, so my visit to mine was mainly to discuss surgery #2.

I WILL say that finding the right PT is vital. My first 2 were the sort that put one on a circuit, X minutes on the bike, X minutes leg presses, etc. and a lot of "no pain no gain" talk with which I completely disagree! As does my next surgeon! My PT is all about healing: and practices cupping and myofascial technique. It helps a lot. My spine has also become out of alignment and my herniated discs have flared up because I contort myself into comfortable positions for my knee. My PT works on my back pain as well. I'm seeing a pain specialist next week for a spinal cortisone injection.

I got my referral to my incredible PT via my town's FB message board! Try networking as much as you can however you can to get the right person!

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@johnbishop

Hi @lindalockie, You mentioned a tourniquet. Was one used during the surgery? I'm in week 3 post op and my care team has told me that controlling the pain was job one and rehab exercises job two. Are you able to discuss your pain with the doctor?

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Hi I am a public patient in Australia Dont see my orthopaedic surgeon until May 23rd Not a lot of support Rehab to be done at home by yourself!! Had Spinal block for surgery and a tourniquet was used around the thigh apparently for blood free surgery I had lots of bruising around thigh
Can only take Paracetemol as allergic to all opioid medications but am trying very hard to bend knee and not doing too badly My biggest problem is relentless burning pain down my thigh calf and foot Pregabalin (prescibed by my GP DR) helps a little bit but make me very groggy I get results of a CT tomorrow so pain could be also due to Spinal block or I think the pain may be attributed to past spinal problems so goodness knows what happens to you during surgery
Been told it may take months to resolve but I need to be able to drive very soon as my husband is having a hip replacement on 8th May so will have to stop the pregabalin or will not be able to drive Just wondered if others had experienced this type of pain after TKR Thank you

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@ethanmcconkey

Hi @lindalockie that must be awful having so much pain and not being able to take most painkillers.

I wanted to introduce you to @debbraw @ellerbracke @johnbishop @babette @sraley1 and @contentandwell as they all have had TKR's and may be able to offer you their experience with pain.

Back to you @lindalockie what have your doctors or physical therapists said about your pain?

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Hi Ethan my pain could be due to tourniquet used during surgery or problems relating to Spinal Block used as anaesthesia or spinal problems from before surgery but I have never experienced pain so debilitating Thank you for your support

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@lindalockie

Hi I am a public patient in Australia Dont see my orthopaedic surgeon until May 23rd Not a lot of support Rehab to be done at home by yourself!! Had Spinal block for surgery and a tourniquet was used around the thigh apparently for blood free surgery I had lots of bruising around thigh
Can only take Paracetemol as allergic to all opioid medications but am trying very hard to bend knee and not doing too badly My biggest problem is relentless burning pain down my thigh calf and foot Pregabalin (prescibed by my GP DR) helps a little bit but make me very groggy I get results of a CT tomorrow so pain could be also due to Spinal block or I think the pain may be attributed to past spinal problems so goodness knows what happens to you during surgery
Been told it may take months to resolve but I need to be able to drive very soon as my husband is having a hip replacement on 8th May so will have to stop the pregabalin or will not be able to drive Just wondered if others had experienced this type of pain after TKR Thank you

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Hi @lindalockie, sorry to hear about the pain. I wasn't aware of the use of a tourniquet for knee surgery. I found an article that may shed some light on the why the pain...

Effects of Tourniquet Use on Quadriceps Function and Pain in Total Knee Arthroplasty
-- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258487/

Why I stopped using a tourniquet for total knee replacement
-- https://www.yourorthomd.com/orthopedic-knowledge/why-i-stopped-using-a-tourniquet-for-total-knee-replacement

Have you thought about alternative methods for helping with the pain? There is a great discussion on Connect that may provide some help for your pain here:

> Groups > Neuropathy > Myofascial Release Therapy (MFR) for treating compression and pain
-- https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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@johnbishop

Hi @lindalockie, sorry to hear about the pain. I wasn't aware of the use of a tourniquet for knee surgery. I found an article that may shed some light on the why the pain...

Effects of Tourniquet Use on Quadriceps Function and Pain in Total Knee Arthroplasty
-- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258487/

Why I stopped using a tourniquet for total knee replacement
-- https://www.yourorthomd.com/orthopedic-knowledge/why-i-stopped-using-a-tourniquet-for-total-knee-replacement

Have you thought about alternative methods for helping with the pain? There is a great discussion on Connect that may provide some help for your pain here:

> Groups > Neuropathy > Myofascial Release Therapy (MFR) for treating compression and pain
-- https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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Hi John thank you very much for the information I will investigate and hopefully get some answers THANK YOU

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John - Thank you for posting this. At 9 months post-op I continue to have so much soreness in my quadricep that going up and down stairs is very painful. Can't believe my surgeon didn't mention this possibility to me! I have found riding a stationary bike to be somewhat helpful with my quads.

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@babette

John - Thank you for posting this. At 9 months post-op I continue to have so much soreness in my quadricep that going up and down stairs is very painful. Can't believe my surgeon didn't mention this possibility to me! I have found riding a stationary bike to be somewhat helpful with my quads.

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Hi @babette, I'm 20 days post op and am able to get around mostly with a cane. I do use the walker at night for bathroom trips. I have a recumbent bike / elliptical combo and can just barely use the bike mode now with the pedals extended as far as they go. I can tell it's much better for exercising the range of motion than the elliptical. I can only do 5 to 10 minutes at a time now but I think once I get a little more range of motion it will be better.

Going up stairs didn't used to be a problem with a crutch or cane but lately I get a sharp pain once in awhile at the joint below the left hip which is opposite of the knee replacement. I'm hoping it's just a strained muscle or ligament. I do take the stairs pretty slow though. ☺ I think what has really helped me was that I had been trying to get a knee replacement for a year due to bone on bone but because I described my pain level at 4 to 5 they wanted to try PT (didn't work) and steroid shot (worked until I knelled down on concrete a few weeks after the shot). So I worked on pre-knee replacement exercises and PT for around 3+ months daily until I was able to get the knee replacement scheduled.

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