Trouble sleeping after TKR: What helped you sleep?

Posted by jackieboo1 @jackieboo1, Nov 2, 2018

I am a 60 year old woman 2 months post op from left knee replacement. I am having trouble sleeping. My knee feels like a square peg in a round hole. Tried pillow between legs, Tylenol and ice. Nothing seems to help.
Suggestions?

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@cindymattern

I am 4 weeks post tkr and have a sleep number bed with an adjustable base. I have found if I raise m legs and sleep with the back reclined somewhat I can sleep for 6-7 hours. I also fall asleep with ice on my knee. Range of motion is now 107 and still working to get more. It's definitely a process

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You're doing great. If you want to sleep on your side, sleep on the side of the non-surgical knee with a long pillow between your legs.

All the best in your recovery!

Joe

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@apriljoy

How are you doing with your revision. I’m facing that and hoping it will help after 5 years of constant pain.

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april - what went wrong with your first replacement? Joe

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jackie - make sure you use a long pillow to place between your legs when sleeping, long enough to support your knees and feet. And make sure to sleep on the side of the non-surgical knee. I hope that helps.....

Joe

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I had a right TKR over 4 mos ago. I did all of the pre and post-op exercises as instructed, and finished the PT that the surgeon ordered. My numbers look pretty good with regard to flexion and extension. My pain level is manageable with Tylenol, as long as I stay ahead of it. My surgeon released me from his care until next July so everything was good with him. I graduated from PT on Halloween but I've been going back on my own three days a week and exercising at home on the off days.

My biggest issue is that I am still unable to sleep in my bed. I have been sleeping in the recliner since I came home from the hospital and it is getting old! I can sleep in the bed, lying down, for about an hour, but the pain will eventually wake me up. I have discussed this with my surgeon, PCP, and my PT folks. The PA at the surgeon's office prescribed a knee immobilizer, which helped tremendously. However, I cannot wear it in bed. I am unable to find a comfortable position.

Has anyone faced this type of issue before and how did you handle it? Thank you!

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@busdriver57

I had a right TKR over 4 mos ago. I did all of the pre and post-op exercises as instructed, and finished the PT that the surgeon ordered. My numbers look pretty good with regard to flexion and extension. My pain level is manageable with Tylenol, as long as I stay ahead of it. My surgeon released me from his care until next July so everything was good with him. I graduated from PT on Halloween but I've been going back on my own three days a week and exercising at home on the off days.

My biggest issue is that I am still unable to sleep in my bed. I have been sleeping in the recliner since I came home from the hospital and it is getting old! I can sleep in the bed, lying down, for about an hour, but the pain will eventually wake me up. I have discussed this with my surgeon, PCP, and my PT folks. The PA at the surgeon's office prescribed a knee immobilizer, which helped tremendously. However, I cannot wear it in bed. I am unable to find a comfortable position.

Has anyone faced this type of issue before and how did you handle it? Thank you!

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Welcome @busdriver57, I moved your question about trouble sleeping 4 months after a TKR to this existing discussion:
- Trouble sleeping after TKR: What helped you sleep?: https://connect.mayoclinic.org/discussion/trouble-sleeping-after-tkr/

I did this so you can read the previous helpful posts and connect easily with members like @dmk @katrina123 @heyjoe415 @artscaping @cindymattern @klarnold @texaslady @swimmergirl and others.

Busdriver, have you tried using wedge pillows?

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I am now 6 months out from left total knee.
This is what I did: I was an active walker for several years, despite pain, up to 3-5 miles 3 x per week. After surgery I did not need the walker after 5-6 days, progressively walked, then reached my goal of 5 miles at 6 weeks postop. Pain medicine was Vicodin twice per day, but stopped it at 2 weeks postop, and took Tylenol prior to PT.
I walking as much as possible preop with friends, stayed fit by going to the gym, controlled my weight
I Have a positive attitude
Used ice for a few weeks
I did my assigned PT visits and did my PT exercises at home
At 6 months I am pain free, and ready to do my right knee in January.

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@colleenyoung

Welcome @busdriver57, I moved your question about trouble sleeping 4 months after a TKR to this existing discussion:
- Trouble sleeping after TKR: What helped you sleep?: https://connect.mayoclinic.org/discussion/trouble-sleeping-after-tkr/

I did this so you can read the previous helpful posts and connect easily with members like @dmk @katrina123 @heyjoe415 @artscaping @cindymattern @klarnold @texaslady @swimmergirl and others.

Busdriver, have you tried using wedge pillows?

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Greetings @busdriver57. And thank you @colleenyoung for the introduction. First of all, let me praise you for diligently doing both your pre and post-surgery exercises. That is so helpful. So, let me see if I can wrap my hands around the sleeping issue in a helpful manner.

First of all...I have had two TKRs and spent no time in a recliner. I did use a wedge pillow and then made sure I ended the day with some ice to go with the appropriate elevation. One question, did you have trouble sleeping before the TKR? Did you take Tylenol for pain before the surgery?

Here are a couple of tips that worked for me.
1. I would lie on my non-surgery side, then lay down a pillow between my legs so that the surgery leg was on the top.
2. I also wrapped my knee in a special ice pack that you can find on Amazon. I kept both of the packs frozen so that there was always one ready.
3. Do you notice swelling in the TKR area? That can indicate a bit of scar tissue or fluid retention. During my PT, my therapist at the sports clinic discussed pain control with my MFR therapist..... which is Myofascial Release Therapy. Because the connective tissue in the knee area can become restricted, it just might help to release it before bedtime.
4. I do Yoga stretches to strengthen the muscles around the knee. The one that helps drain fluid is called "Legs up the Wall". You can find it on Youtube.

And now, one year later, I have no knee pain day or night. However, I do have SFN, (small fiber neuropathy) which can be the cause of pain throughout my body. And for SFN, I use an appropriate dosage of medical cannabis. As a result, I can sleep right through whatever shows up at bedtime.

Have you tried some of these "tricks"? Do any sound helpful? Please let me know what works best for you.

May you be free of suffering and the causes of suffering.
Chris

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Two weeks since TKR. About a week ago started having nights with significant knee pain that radiates down shin, into ankle and sole of foot. Pretty much always starts at midnight and goes to around 5 am. Anyone else have similar experience?

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@evon

Two weeks since TKR. About a week ago started having nights with significant knee pain that radiates down shin, into ankle and sole of foot. Pretty much always starts at midnight and goes to around 5 am. Anyone else have similar experience?

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Hello and welcome to Mayo Connect. Sorry to hear that your sleep is being interrupted, but this is definitely a frequent complaint after joint surgery. We always want to believe we'll "bounce right back" but the truth is, joint surgery is a major assault on the body - bones, muscles, tendons, nerves and soft tissue are all involved. Each heals at its own pace, and each of us feels pain differently.

Two ways I found to ease pain after surgery are ice and Tylenol.
I used my Cryocuff ice machine close to 24 hours a dat for several weeks - even at night. And Tylenol extra strength on a regular schedule helped me stay ahead of the pain.
The other thing many people don't know is that the leg should be elevated whenever you are not "up and doing" - above the heart is best to keep swelling down and to keep the lymphatic fluids moving back toward the body (these carry away the by-products of healing), so add some pillows to the footrest, sofa and bed.
Have you been doing all of this already? If that is not enough, it may be time for a call to the doc for something a bit stronger, or a temporary sleep aid, to allow you to rest.
Sue

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Trouble sleeping post TKR is not unusual. I would get up and go on my stationary bike for 5 minutes or walk around. When lying in bed one doesn’t get the same blood flow as they do during movement. You can also try lying on your back, elevate your legs and do bicycle riding exercises.
Perhaps ask your doctor for a prescription for Lyrica. This helps with nerve pain but also helps with sleeping

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