Pain after recent Knee Replacement. What is normal? For how long?

Hi,

I wonder if the build and/or surgery needs of the patient, and approach a surgeon uses makes a difference. I’m 9 weeks PO with a TKR and can pretty much do anything I want...knock on wood. It has been much easier recovery than my hip. My hip is getting close to 8 months and continues to challenge me.

As far as pain medication, I was given instructions to stagger the medication. I have a pretty high pain tolerance. Off narcotics by day 8 or less for each surgery.

I agree about narcotics, but with knee# 1 I did not do a good job with pain management and ended up with scar tissue bc PT was difficult. I had a compressed L5/S1 nerve making matters worse. I am no wimp and have pushed through two Achilles surgeries. My issue is being able to make sure I can do all of the PT for the knee. I have friends who have had little pain with their TKR and I just don’t get it. I hike, work out, stay busy and just want my life back! If it takes 3 weeks of narcotics to get me over the hump, I am okay with it.

I am only on day 13 and hope to goodness that by 9wk PO I will be back to my life! I was plagued by sciatica with my first knee so I am super conscious of getting the rehab done right this time! So far, so good. Plan to be off narcotics after week 3. Just my body needing more time, I guess!

I hope it goes well for you. My surgeon said, you really have to work the knee with the exercises, so I did. The first 1 1/2 to 2 weeks the heel slides were brutal until the swelling went down. Seemed like the swelling is really what caused the pain when bending in my case.

Thank you! Oddly, my PT has me doing a ball roll and squats vs heel slides. I think he is trying to keep me from involving my back. At day 10 I had 97 flexion so it must be working. He had me rocking the bike on day 5. I’ve got this!

Thank you for that information. If this continues I’m making an appointment with my primary care physician. Some days are good but I’m not where I want to be. Patience may be called for. I pm trying not to be discouraged.

I've had both knees replaced this year. The recoveries went very well. One lingering affect is similar to what you describe. When I stand up from sitting I'll get a sharp, brief flash of pain behind my kneecaps. Maybe that will get better with more time. As someone else wrote, surgery is an assault on the body and it just takes a lot of time to heal. A TKR is common, but still a major surgery.

My pain is in no way debilitating. All the best to you.

Joe

I have been doing pretty good the first couple of weeks and stopped taking pain meds per doctors advice. Taking ESTylenol and Ibuprofen for management. I went to therapy yesterday afternoon and am having a lot of trouble with pain on the outside of my leg - especially when I try bending it since that therapy session. I was not experiencing this before yesterday. The therapist did massage my kneecap and out some pressure on top of my shin. I hardly slept at all last night ( that’s how I found this site) and taking it pretty easy today. Therapist also had me try a couple of new exercises so maybe that is what’s different. Hoping someone else has had this experience or maybe there are good days and not so good days? I feel as though I’m going backwards instead of forwards.

I had a total reverse shoulder replacement last September. I did find that during physical therapy new exercises would ramp up the pain somewhat. Just listen to your body and rest whenever you feel you need to so you can get through the day. I did great during therapy and got released early. Then in May I broke the shoulder in a fall. I'm still being seen by the ortho. This was my left shoulder. Now, I get to address my right shoulder, which is actually in worse shape. The actual surgery was brutal (so much worse than natural childbirth) and I decided to put off the right shoulder until absolutely necessary. I wish you all the best in your recovery. I will add, though, the doctors aren't very keen on writing scripts for pain meds.

@sr108 - Well, I think this line answered your own question, "Hoping someone else has had this experience or maybe there are good days and not so good days? "
Yes, when I rehab (10 0r more ortho surgeries) I refer to the beginning of intense PT as "Two steps forward and one step back."
Remember, joint replacement is a major assault on your body - bones, muscles, ligaments, tendons and nerves, as well as anesthesia & blood loss. Then, you stay still, using ice and elevation for 3 weeks, so muscles atrophy and the body tightens up. And suddenly - it's time to get serious about upping the PT - and it hurts, a lot!

Here is what has worked for me:
ICE, up to 12 hours a day at this stage. It keeps swelling down and numbs the angry nerve endings.
Elevate, whenever you are not on your feet & moving, the knee should be up - at least above your hip or else above your heart. My doc told me at least for 6 weeks, longer if it continues swelling.
Control pain. By this point you are probably alternating Tylenol & Ibuprofen. Keep on doing it, especially before and after therapy sessions. I did it for over 3 months after my last hand surgery, 24/7.
Do your at-home therapy 2 or 3 times a day, no matter how bad it feels. Once a day is not enough to make progress.
Walk - at least as far as recommended every day. Challenge yourself to increase a little each day.
Rest - Your body is still healing. Once or twice a day, nap for 30-60 minutes. Phone, devices & TV off, in recliner or bed. Sleep is restorative & short naps will not interfere with night-time sleep.
Distract - Find something you can do while seated & elevated to keep you distracted so you don't dwell on your pain. (Not recommended - endless screen time or news-binging. Reading endless posts about pain and suffering. Recommended - read, engage in a hobby, learn a new (sedentary) hobby, chat with friends on the phone.)

Hang in there - breaking up newly forming scars HURTS, but you will be happy later to be able to move more freely. Forcing the new joint to move farther each day HURTS. Healing muscles can hurt or ache. Expect there to be some tingling, numbness or pain while the nerves heal. This is normal and varies from hour to hour and day to day.
You will gradually feel better until one day, you look up and say "Wow, I haven't thought about my knee for a whole hour."
Are you having a better day today?
Sue