Debilitating pain 6 months after knee replacement
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?
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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.
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.
@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.
@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.
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.
The most common causes of pain after knee replacement is Loosening of the implant. You can reduce pain by doing your postoperative exercises.
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.
@canis I'd recommend seeking out a pain specialist. So sorry your husband is going through this – I'm having a long "recovery" too.
I feel for everyone who is continuing to experience pain after their replacements. I am 1 1/2 yrs out from a partial knee replacement and still have daily pain. My surgeon cannot find any reason as to why I'm still experiencing pain. All x-rays look normal. I was in Physical Therapy for over almost a 1 1/2 years – starting about 6 months prior to my surgery. At about the 9 month mark my primary care provider gave me a referral to a pain management specialist (at this point I was diagnosed with stomach ulcers and was unable to continue on the NSAIDS that kept the pain bearable) since no other orthopedic surgeons would see me as a 2nd opinion until the year mark. The pain management doctor ordered a spine MRI to see if the pain could be referred pain from a spine issue – that was normal. He also ordered a bone scan – also normal. At this point we were at around the year mark. I saw my original surgeon for my year follow up, once again he couldn't find any reason for the pain and said the only thing he could think of to possibly help would be to convert to a total knee, but he couldn't offer any guarantees. Definitely not what I wanted to hear. He was very proud of me for my weight loss since surgery (around 40 pounds) – of course, my weight loss was all related to the stomach issues I had been experiencing because of the damage done by the NSAIDS he prescribed. Since it had been a year, I had a second opinion with a surgeon from University of Wisconsin – about 2 hours away – to see if they could find any reason for the pain. That surgeon ordered a MRI, which did show some arthritis on the other components of the knee, but not enough to warrant converting to a total nor enough to explain the pain. Right now, I'm working with my pain management doctor to try to get a nerve block and/or ablation covered by my insurance company to see if that will bring me some relief. I'm also recovering from gastric bypass surgery due to the stomach damage from the NSAIDS and am struggling with my weight – I went from being morbidly obese 2 years ago to borderline underweight and significantly malnourished. Knee surgery is not an option at this point in time. I'm 43 years old – was once very active walking at least 3 miles a day. Now I go to work, struggle to walk from my car to my desk, come home and sit in my recliner watching tv. I'm also battling depression. There are days I wish I never would have had the surgery – although the rational me knows that I was in significant pain prior as well. I thank God for a great primary care provider who has prescribed Tramadol to assist with the pain (although I would rather not take it, and try not to as much as possible, but there are some days I just can't bear it) and Ambien to help me sleep at night. Without those 2 medications I'm not sure I would be making it as "well" as I am.
@kibe75 – I am so sorry about the level of pain you are having so long after your PKR. I'm 68 years old and had a TKR in January. After 3 weeks, I had a terrible reaction to the Celebrex I was prescribed. They took me off all pain meds for a few days then let me start on Tramadol. I can really relate to how grateful you are to have that! Thankfully, my TKR recovered well and I have no pain from it. However, I'm scheduled for an endoscopy next week to see if the ulcer has healed in my stomach. (Wish me luck!) Back to you – is the pain you are having now with your knee the same kind of pain that caused you to have the PKR or is it different in nature or intensity? I just feel so bad for you – you are too young to have this kind of debilitating pain.