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Severe Pain after 2nd TKR

Posted by ssbionicknee @ssbionicknee, Sep 8, 2019

I had a right TKR in May of 2018 and it was painful, but tolerable. Physical Therapy seemed to go fairly smoothly. In August of 2019, I had my left TKR and am having a horrible time controlling the pain and Physical therapy is not going near as smoothly. I went to PT last Friday and was in extreme pain afterward. I was up all night. I had sharp pains inside the wound, extreme sensitivity to touch on the inside of my knee, what felt like spasms in the back of the knee and the knee was very sensitive to anything touching it. I had to keep it still and iced all day Saturday in order to get the pain under control. I know I need to do my exercises, but am afraid of triggering the pain again. I have heard that no 2 knee replacements are the same, but this one seems to be really bad. Is this normal? I have to find a happy medium when doing physical therapy. Any thoughts or suggestions?

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JK | @contentandwell | Sep 16, 2019
In reply to @ssbionicknee "@contentandwell My goal is to get to the point where I no longer need the Lyrica..." + (show)
@ssbionicknee

@contentandwell My goal is to get to the point where I no longer need the Lyrica or pain meds. I wasn't thrilled about taking the Lyrica, but for now it is the only way I can get the range of motion back in m knee. It has also allowed me to cut way back on pain meds. I have to admit my therapist is awesome!! In the past few years, I have fallen apart and have needed therapy. I have been seeing the same PT for about 2 and a half years now. I trust him when he is working on my knee. I know that if I get to the point of agony he will stop and try something new. At one point he did tell me that therapy did not have to be agonizing, that there were many other options to try. The water therapist has been great, as well. There are 2 patients with the therapist and her assistant. I get one on one attention the entire time I am there. I am sorry you had a bad experience.

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@ssbionicknee I don’t think that the physical therapist had another patient, I think she was flirting with one of the male PTs!

The therapist I have used more recently had been very good until the last time I used him. My orthopedic surgeon wants “gentle PT”. The in-house PT knew how to deal with that and he respected it because he had worked with other patients of that doctor and knew he has a phenomenal success rate. The outpatient PT was at a loss as to what to do though.

Good PTs are hard to find I think, I have used a number of them. You are very fortunate to have found such good ones.
JK

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donheads | @donheads | Sep 18, 2019
In reply to @ssbionicknee "@contentandwell My goal is to get to the point where I no longer need the Lyrica..." + (show)
@ssbionicknee

@contentandwell My goal is to get to the point where I no longer need the Lyrica or pain meds. I wasn't thrilled about taking the Lyrica, but for now it is the only way I can get the range of motion back in m knee. It has also allowed me to cut way back on pain meds. I have to admit my therapist is awesome!! In the past few years, I have fallen apart and have needed therapy. I have been seeing the same PT for about 2 and a half years now. I trust him when he is working on my knee. I know that if I get to the point of agony he will stop and try something new. At one point he did tell me that therapy did not have to be agonizing, that there were many other options to try. The water therapist has been great, as well. There are 2 patients with the therapist and her assistant. I get one on one attention the entire time I am there. I am sorry you had a bad experience.

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Can you tell me when you say lack of motion how restricted are you? I have no bend what so ever. I am awaiting a second opinion as to what is causing this.

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1 reply
zakcat | @zakcat | Sep 18, 2019
In reply to @babette "I'm sorry you're experiencing so much pain! My first response to your post is: I'm wondering..." + (show)
@babette

I'm sorry you're experiencing so much pain!

My first response to your post is: I'm wondering if you might have an infection. I'd call your surgeon or whomever is covering for him or her, now.

My second response is that maybe the PT is too intense/damaging to such newly traumatized tissue. In my 1+ year adventure into the world of TKRs I've learned that there are basically 2 approaches to PT. One is "no pain, no gain," the other is much gentler. The high pressure PT "circuit" didn't work well for me and I had so much pain afterwards that I would miss the subsequent session. I found a gentle DPT who has helped immensely.

I hope you'll post again after you speak to a doctor.

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You are right about avoiding overly aggressive PT. My first one had me crying so hard. Another PP told me that should not happen. I switched therapy company, and found a very effective PT who worked me just hard enough to be effective. I gained 10 degrees every week! Too much Pain is not good therapy technique!

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ssbionicknee | @ssbionicknee | Sep 20, 2019
In reply to @donheads "Can you tell me when you say lack of motion how restricted are you? I have..." + (show)
@donheads

Can you tell me when you say lack of motion how restricted are you? I have no bend what so ever. I am awaiting a second opinion as to what is causing this.

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@donheads Because I had to stop bending my knee and let the pain ease up, I lost any range of motion I had gained. My PT is working on bending the knee again. I barely have any bend in the knee at all. While the Lyrica helps, it takes all my energy to focus on breathing so I can get through my PT working on my bend. This knee surgery has been a roller coaster ride. It seems like every step I take forward, I end up taking 2 steps back. The PT has been working on my T band and I have been massaging it at home, but today he said that it wasn't looking good. I am hoping that it is not scar tissue. I do not want MUA.

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2 replies
JK | @contentandwell | Sep 20, 2019
In reply to @ssbionicknee "@donheads Because I had to stop bending my knee and let the pain ease up, I..." + (show)
@ssbionicknee

@donheads Because I had to stop bending my knee and let the pain ease up, I lost any range of motion I had gained. My PT is working on bending the knee again. I barely have any bend in the knee at all. While the Lyrica helps, it takes all my energy to focus on breathing so I can get through my PT working on my bend. This knee surgery has been a roller coaster ride. It seems like every step I take forward, I end up taking 2 steps back. The PT has been working on my T band and I have been massaging it at home, but today he said that it wasn't looking good. I am hoping that it is not scar tissue. I do not want MUA.

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@ssbionicknee oh no, I’m sorry to hear that you’ve lost range of motion. I actually did too. When I had the in-house PT my flex was just over 120 and he was confident that I would reach at least 125. Then I went to the outpatient PT and it went down to about 117. I know, that’s not bad but I really set my goal at 120.

Hopefully your flex has not decreased to the point of needing MUA. There is another procedure that is easier that can improve flex a bit. Has your surgeon mentioned that? I would to need to go back to my old notes to find what the name of it is but if you want to know I will be glad to. I think it’s something like lysis.
JK

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2 replies
zakcat | @zakcat | Sep 21, 2019
In reply to @ssbionicknee "@donheads Because I had to stop bending my knee and let the pain ease up, I..." + (show)
@ssbionicknee

@donheads Because I had to stop bending my knee and let the pain ease up, I lost any range of motion I had gained. My PT is working on bending the knee again. I barely have any bend in the knee at all. While the Lyrica helps, it takes all my energy to focus on breathing so I can get through my PT working on my bend. This knee surgery has been a roller coaster ride. It seems like every step I take forward, I end up taking 2 steps back. The PT has been working on my T band and I have been massaging it at home, but today he said that it wasn't looking good. I am hoping that it is not scar tissue. I do not want MUA.

Jump to this post

Don't fear the MUA too much. It can really help, and it's not as bad as you are expecting.

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1 reply
damewocane | @damewocane | Sep 28, 2019

Sadly, I've been through it all,TKR, MUA ,hours of painful PT with only 68 degree bend( 2018) Now 2019 New ortho Dr , revision, hours of painful Pt, hip replacement, MUA,more screaming ,crying PT still only 68 degrees-finally went to pain management specialist-exploring the possibility that this is all emanating from L3 and L4 nerve damage- MRI and Emg next...omg

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2 replies
Debbra Williams, Alumna Mentor | @debbraw | Sep 28, 2019
In reply to @damewocane "Sadly, I've been through it all,TKR, MUA ,hours of painful PT with only 68 degree bend(..." + (show)
@damewocane

Sadly, I've been through it all,TKR, MUA ,hours of painful PT with only 68 degree bend( 2018) Now 2019 New ortho Dr , revision, hours of painful Pt, hip replacement, MUA,more screaming ,crying PT still only 68 degrees-finally went to pain management specialist-exploring the possibility that this is all emanating from L3 and L4 nerve damage- MRI and Emg next...omg

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@damewocane - Wow... what you have been through...How are you holding up? When is your MRI?

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ssbionicknee | @ssbionicknee | Sep 28, 2019
In reply to @contentandwell "@ssbionicknee oh no, I’m sorry to hear that you’ve lost range of motion. I actually did..." + (show)
@contentandwell

@ssbionicknee oh no, I’m sorry to hear that you’ve lost range of motion. I actually did too. When I had the in-house PT my flex was just over 120 and he was confident that I would reach at least 125. Then I went to the outpatient PT and it went down to about 117. I know, that’s not bad but I really set my goal at 120.

Hopefully your flex has not decreased to the point of needing MUA. There is another procedure that is easier that can improve flex a bit. Has your surgeon mentioned that? I would to need to go back to my old notes to find what the name of it is but if you want to know I will be glad to. I think it’s something like lysis.
JK

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@contentandwell JK, my bend went halfway between straight and 90 degrees. Last week the IT band was extremely tight. I spent the weekend massaging it and doing my exercises to loosen it up. When I went to PT on Tuesday the bend was better, but not at 90. The tendon on the inside of my knee is extremely sore, I came home on Thursday and massaged it util it was bruised to try and loosen it up. I made it to 90 on Friday, but it takes evey ounce of my concentration to get it to bend. Today (Saturday) it is too sore to touch and it has hurt all day. It will bend to maybe 80 (I am just estimating) and then it is like it just can't move anymore. I am one of those people that is bound and determined to make ot work, but the knee just stops and then won't move. My PT said he did not like the way the knee was responding to therapy. I start PT once a week begining the second week of October. Last time I was much further along. I have not been able to ride the stationary bike, I am still walking with a cane, and there are a lot of things that I am not able to do at this point. It is extremely frustrating.

REPLY
ssbionicknee | @ssbionicknee | Sep 28, 2019
In reply to @contentandwell "@ssbionicknee oh no, I’m sorry to hear that you’ve lost range of motion. I actually did..." + (show)
@contentandwell

@ssbionicknee oh no, I’m sorry to hear that you’ve lost range of motion. I actually did too. When I had the in-house PT my flex was just over 120 and he was confident that I would reach at least 125. Then I went to the outpatient PT and it went down to about 117. I know, that’s not bad but I really set my goal at 120.

Hopefully your flex has not decreased to the point of needing MUA. There is another procedure that is easier that can improve flex a bit. Has your surgeon mentioned that? I would to need to go back to my old notes to find what the name of it is but if you want to know I will be glad to. I think it’s something like lysis.
JK

Jump to this post

@contentandwell JK, I would like to know the name of the procedure if it is not to hard to look up. I have also heard that dry needling can help. I am not sure about that though. I've heard it hurts and then I've heard it does not hurt. Thank you!!

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