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

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.

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I had total knee replacement surgery three weeks ago and am having a similar experience with recurrent pain -- as well as inflammation/swelling -- seeming to be getting better, but then getting worse again. I often feel just as you do too that my overall level of pain and range of motion are simply regressing at times, despite my keeping up with my physical therapy routines, which is disappointing, if not cause for some intermittent despair. I'm surprised just how much inflammation/swelling remains and how tight and restricted my joint still feels three weeks post surgery.

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I had both knees replaced at Mayo Phoenix last year 3 months a part. I am a super active 73 year old. I experienced a little bit of the same things you are feeling after the second surgery. Surgery does a number on your body. It is traumatic to your system. I give blood at the Red Cross about every 8 weeks. When I went in about two months after surgery, my hemoglobin was lower than their policy allows for blood draw. I was surprised, but that was the reason for being a bit lethargic, workouts were not as aggressive, I tired more easily, had a bit of low stamina. I was anemic according to the numbers. When I discussed this issue with the fine doctors at Mayo, and after reviewing if I had any other trauma or blood loss, they suggested I CAREFULLY take an iron supplement and that . Too much iron can be dangerous. In Arizona you can schedule your own battery of blood tests without a prescription. I think the hemoglobin test was $25.00. I did it to double check what the Red Cross numbers indicated. It was low: 12.1. It should between 13.8 and I think 17. Even with taking the iron supplement, it two more months to get it to my pre-surgery level of 15.2. Talk to your Doc. This may be what's happening.

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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.

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@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

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Hi @oceanspruce, Three weeks is still pretty early in the recovery process. Are you doing a lot of icing and elevating of the leg during the day? The reason I ask is because I thought I was until my post surgery followup with the surgeon and found out my idea of icing and elevating was not what he was telling me to do - anytime I was sitting and not doing the post op stretches and exercises, I needed to keep the leg elevated and frequently iced to keep the swelling down.

That really helped with my inflammation and swelling and I slept a lot better at night.

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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.

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Im having TSR in one month and have decided to purchase a wedge pillow for my bed so when I get tired of recliner Ill have somewhere else to lie down. Ive found a 12' wedge pillow but am concerned about lower pain pain from head being elevated. What brand has worked for anyone else with these concerns?

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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.

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Hi John,

Yes, I have been elevating and icing regularly but not constantly between my other activities including walking, physical therapy exercises, eating, using the bathroom, traveling as a passenger in a car, etc. I've had seven in-home physical therapy sessions with five different therapists so far, and last week one of them told me that when I was elevating and icing while remaining in a upright seated position, such as when I'm sitting on a sofa, I wasn't receiving much anti-inflammation, anti-swelling. She told me in order to receive the full benefit of elevating and icing I need to have my back flat down on the sofa or bed with my leg ABOVE the level of my heart. Since then I've tried to be in that position more often, but it's difficult to remain in that position for so much time day after day after day. Also, my surgeon is reluctant to prescribe me (or other of his joint replacement recipients) anti-inflammatory medication because of several of its possible negative side effects, especially damage to the kidneys. However, upon my specifically inquiring about such medication at my 16-day, post-surgery follow-up appointment three days ago, he did relent and agree to prescribe me seven (7) 200 m.g. Celecoxib (Celebrex) to be taken once a day for seven (7) days. I'm hoping with these adjustments to my recovery regimen I might see some improvements.

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