Sciatica after knee replacement

Dear shawndm,

Associated, yes, perhaps not caused by surgery though.

I say associated because as we age joint issues appear!
If we had xrays of 100 people on this joint replacement sharing group, I would bet most, if not all, would show some wear and tear * of knees, hips, sciatic, lumbosacral, and perhaps other joints. *(degenerative changes, loss of cartilage)

That said, if you have gait issues, swelling, and pain it may be prudent to ask questions of professionals, perhaps start with a physical therapist?

Best wishes

There certainly is a connection, but as the previous poster said, there are so many joints that normally deteriorate as we age, that you can't just assume a one to one cause. In my case, I developed sciatica in my left hip in the year after having TKR on my right knee. TKR recovery went quickly and very soon I was putting normal weight on the surgical knee. But since my right knee no longer hurt, I was adjusting my now painful left leg to be more on tippy toe walking to avoid pain on that side, and twisting some while I walked. After having a TKR the following year on my left knee, the sciatica was gone in a few weeks and has not returned now that my gait is equal on both sides. I should mention that my left leg/foot was turning in very pigeon toed, and the surgeon said he would fix that during the TKR. It has now been 6 and 5 years since the surgeries, and I have no issues.

I’m really sorry you’re going through this. It’s not uncommon for changes in gait after a knee replacement to put extra stress on surrounding muscles and tendons, which in some cases can contribute to IT band issues or even irritate the lower back/nerve pathways linked to sciatica. Persistent swelling can also affect movement patterns over time.

I’d suggest discussing this with both your orthopedic surgeon and a physiotherapist, they can check your gait, muscle imbalances, and spine alignment. Sometimes targeted physical therapy, stretching, and strengthening exercises help relieve IT band pain and take pressure off the sciatic nerve.

It does sound like there could be a connection, but getting a specialist to review your case in detail would give you the best path forward.

I totally understand. I had both TKA the most recent one was in July 2025 and I have recently been experiencing left sciatica pain and I know why. I have a sit down job and have been sitting down more than usual. I had the pain during my third week of recovery and boy was it painful and now it has return. I have started to move around, stretch and walk . I have learned to push through the pain not letting take over my life and pray trusting God . I’m not letting the old lady in at 53