Chronic,debilitating pain 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?

@rosiegirl

The surgeon who did the TKN retired only 6 months after my surgery (he was only 60!). I am not happy with the surgeon to whom he referred me, so I am scheduled next week to see a surgeon my family doc recommended. I had been swimming until about 2 or 3 months ago, when it became too painful to do so. Had to stop exercising except for a few core exercises.
Thank you for your response.

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Hi @rosiegirl – I want to add my Welcome to the others. Glad you are here on Connect! It must be awfully discouraging to have the pain/swelling you have had and THEN have your doctor retire. I'm glad you are seeing another surgeon. I've had two TKRs – one in 2017 and the last one earlier this year. My surgeon told me that many people have problems kneeling after surgery. That has been true for me. He also said that many people report that kind of popping or clicking noise. I have not had that. So while I wouldn't necessarily be too concerned about the kneeling or the sound, I would be worried about the bending backwards, the pain and the continued swelling. It sounds as if you are doing all you can do to get to the bottom of the problem. Have you prepared a list of questions for your new doctor? If I were you, I would jot some down – along with some of the things you have told us here like when you had to quit swimming and how the pain has gotten worse and worse (not better and better). If you are anything like me, I have the timeline and questions in my head, but the facts don't necessarily make it out of my mouth when the doctor steps in. Will you let us know how your new doctor visit goes?

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@contentandwell

@rosiegirl I hope the new doctor can help you, but if not do not give up. I have found that sometimes doctors are influenced by personal feelings toward a doctor. I have had that happen a couple of times. Check out the doctor's ratings on things like Vitals and Healthgrades. I never believe the ratings unless there are a substantial number of them though.
JK

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It seems that mznyndoctors really don't listen, which is the problem I had with the doctor referred by my original orthopedist. I agree about the ratings. The surgeon I will be seeing has excellent ratings, and my family physician told me other patients of his were very happy with him. . Additionally he is the team sports doc for local university's teams. Keeping my fingers crossed.

Thank you

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I have experienced the popping since my TKR, but until a few months ago it was not associated with any pain. Something has definitely changed, and I am hoping that this new surgeon will be able to help me. If not, I'll keep searching for a resolution. I already have a script prepared for the new orthopedist. I want to make sure I don't leave anything out.

Thank you.

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@rosiegirl

It seems that mznyndoctors really don't listen, which is the problem I had with the doctor referred by my original orthopedist. I agree about the ratings. The surgeon I will be seeing has excellent ratings, and my family physician told me other patients of his were very happy with him. . Additionally he is the team sports doc for local university's teams. Keeping my fingers crossed.

Thank you

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@rosiegirl It sounds as if you are doing all of the right things. Generally, orthos who do sports teams are very good.

@debbraw is right — prepare a list and make sure you get through the list. I had a PCP appointment a couple of weeks ago and afterward, I realized I had neglected to put a couple of things on my list. I try to remember to jot them down as I think of them, but I sometimes tell myself that I will remember, and then I don't.

I hope you will let us know how the appointment goes, and that the new doctor finds something that he can help you with.
JK

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HI Everyone, It does seem that knee discomfort and pain continue for a long while for some people. I'm 4 months out and have extremely tight bands around my knee. I had relief for about a week when taking Meloxicam but it all came back. I walk and exercise but fine it easer to do things if I warm up first. i.e. leg on ball with strap under foot gently back and forth. So it seems not to go away. My pt offered "Ive never seen anyone lay down scar tissue like you." So I guess keep moving.

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Hi all – Add me to the list of people with long "recoveries." I had my surgery just a few days after rosiegirl — July 2018 — and continue to encounter problems. I have pain with stairs, especially going downstairs when my (right) surgery leg is the one behind, if that makes sense. Overall though, my knee is getting *much* better when in the car, sitting, and walking, but it still feels strange. I attribute recent improvement to at home PT/stationary bike and to finding a *gentle* physical therapist who practiced cupping, myofascial release, and massage. Her work really made a difference. I can also relate to rosiegirl's sensitive scar – I went through the entire winter unable to wear *anything* that rubbed my scar, tights, jeans, everything. It made life pretty miserable. Only now can I wear jeans, etc. This entire experience has made me willing to do *anything* to avoid having my L knee replaced. I hear there are gel-type injections, now being used instead of cortisone shots. I think that's my next step.

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@babette

Hi all – Add me to the list of people with long "recoveries." I had my surgery just a few days after rosiegirl — July 2018 — and continue to encounter problems. I have pain with stairs, especially going downstairs when my (right) surgery leg is the one behind, if that makes sense. Overall though, my knee is getting *much* better when in the car, sitting, and walking, but it still feels strange. I attribute recent improvement to at home PT/stationary bike and to finding a *gentle* physical therapist who practiced cupping, myofascial release, and massage. Her work really made a difference. I can also relate to rosiegirl's sensitive scar – I went through the entire winter unable to wear *anything* that rubbed my scar, tights, jeans, everything. It made life pretty miserable. Only now can I wear jeans, etc. This entire experience has made me willing to do *anything* to avoid having my L knee replaced. I hear there are gel-type injections, now being used instead of cortisone shots. I think that's my next step.

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@babette I'm glad to hear that things are getting better for your knee. I feel so fortunate to not have encountered any of the problems mentioned. My scar was never sensitive, and other than not having quite as much flex as I would like I couldn't ask for more. They say every TKR is different. I can understand your reluctance to undergo another but just because you struggled with one does not mean a second one would cause the same problems. I have even heard of people having bi-lateral TKRs and the two knees being totally different in recovery.
JK

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@babette

Hi all – Add me to the list of people with long "recoveries." I had my surgery just a few days after rosiegirl — July 2018 — and continue to encounter problems. I have pain with stairs, especially going downstairs when my (right) surgery leg is the one behind, if that makes sense. Overall though, my knee is getting *much* better when in the car, sitting, and walking, but it still feels strange. I attribute recent improvement to at home PT/stationary bike and to finding a *gentle* physical therapist who practiced cupping, myofascial release, and massage. Her work really made a difference. I can also relate to rosiegirl's sensitive scar – I went through the entire winter unable to wear *anything* that rubbed my scar, tights, jeans, everything. It made life pretty miserable. Only now can I wear jeans, etc. This entire experience has made me willing to do *anything* to avoid having my L knee replaced. I hear there are gel-type injections, now being used instead of cortisone shots. I think that's my next step.

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@babette I'm 5 months post-op bilateral and have plenty of pain in right knee, left is getting better. The therapist I see is like yours with the gentle bending and myofascial release. What has cupping done for you? My scars are sensitive too, I've cut a lot of my pants off at the knee! I've been wearing shorts since January.

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@doodles418

@babette I'm 5 months post-op bilateral and have plenty of pain in right knee, left is getting better. The therapist I see is like yours with the gentle bending and myofascial release. What has cupping done for you? My scars are sensitive too, I've cut a lot of my pants off at the knee! I've been wearing shorts since January.

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Although my swelling never went down after my surgery, the pain was minimal. It's only been weeks, almost 2 years since the TKR, that the pain has started to impact my mobility and ability to sleep. I have not gone back to PT. I am waiting until I see the surgeon before doing anything.
I hope that you find relief soon and your swelling starts lessening soon.
Thank you.

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The most common causes of pain after knee replacement is Loosening of the implant. You can reduce pain by doing your postoperative exercises.

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I am so sorry to hear your husband is dealing with this pain. Believe me, I can relate. I am going on 6 months bilateral TKR and I've been in constant pain with very limited mobility. My gait is painful to watch and I can't stand for more than 10 minutes. My last visit with surgeon in May did not give me any answers to my pain, which is almost always around 4-5 reaching 8-9 in the afternoon and evening. He said the xrays look good, blood work does not indicate infection. I told him maybe the standing straight in front of an xray looks good, it's the movement of the knees when walking that feels very "off". He refilled pain meds (which I would rather not be taking) and said see ya Labor Day if it's not better. I have felt since April that this is not right for a recovery. I am 62, was very active, riding my bike 20 miles, enjoying the Art Festivals, taking care and chasing after my grandchildren. I've been very healthy, weight has always been good and I did pre-hab exercises and was diligent with my PT rehab at home. I was not happy with my surgeon so I did find another ortho surgeon to give me a 2nd opinion. He has found the implants to be too big for me. I am 5'3 120lbs small boned. He is suggesting revisions. I am going for a 3rd opinion before I make any decisions. Maybe your husband should also seek a 2nd opinion and focus on the size.

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@canis I'd recommend seeking out a pain specialist. So sorry your husband is going through this – I'm having a long "recovery" too.

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