TKR serious burning inside of knee

Posted by bluesquirrel @bluesquirrel, Dec 1, 2021

I am 10 days out from my second TKR. About 4 or 5 days ago the inside of my knee started to burn and today it's like a hot coal sitting on my knee burning into it!
What is this burning and how can I get rid of it? It is going to mess up PT because I cant even do the exercises I need to do.
The area is a little warm but not excessive, it's not red except for a bruise near it. But the pain is unbearable and I end up in tears constantly!
Anyone have any knowledge about this and anything I can do to get rid of it. Ice helps some, but once the ice comes off the burn comes back. Not always full on, but still quite painful. I cant even narrow down what really brings it on or anything except the ice helps some.
I've seen other posts about this, but not any answers. I'll keep looking but hope someone can respond and help me out. Thanks!

Interested in more discussions like this? Go to the Joint Replacements group.

Good evening @bluesquirrel. Welcome to Connect. It must be very frightening to experience pain that has you crying. I just opened your post and want to see if I can help. I had my second TKR 3 months ago and don't think I had what you describe as burning. However, other Connect members have used the word burning to describe their post-surgery pain.

I would appreciate it if you would answer a few questions for me. Number 1…..what medication were you given to control pain? Are you also taking medication to prevent inflammation? In addition to the ice for 15 to 20 minutes frequently, are you elevating your knee above your heart? Was this a robotic surgery and did you have a nerve block?

And,,,,,, your are correct, pain will mess with your PT. Are you going to an orthopedic center for PT or is someone coming to your home to help you? Have you shared your concerns with your therapist? Most importantly have you discussed your pain situation with your surgeon? If so, what was recommended to help alleviate the discomfort?

I will wait this evening for your reply and see what else might be appropriate and helpful. Connect is dedicated to improving the quality of life for every member. Let's get started by having a mutual understanding of your status.

By the way, do you recall the recovery from your first TKR? How is this one different?

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

REPLY

@artscaping
I just typed up an answer and lost it, so I will try to get all info here again.
My medication started out with tylenol and oxycodone for pain and Celebrex for swelling.
I ended up in the ER 3 days after surgery for back pain (sciatica like) and got a shot of dilauted and a prescription for a few pills. That helped the pain immensely for a few days. I called my surgeons office and explained what was going on, they took me off dilauted and replaced it with a steroid pack which helped for the first day, but the second hadn't felt like it did anything (that is the day of original post).
I elevate quite a bit and also have the machine (cpm, or cpt ?) that moves my leg from straight to bent and do that as the PT said, 45 to 60 minutes 3x daily, or more if possible. I even sleep using it because otherwise pain is worse yet! I did tell PT about the burning and he did some pressure point thing that helped for most of that day, but did come back later.
I am not great with pain, and then I get in my head about falling behind with PT and hindering my progress, ugh!
My last TKR was a hot mess, the pain was bad then and the pain pills irritated my ulcers, which turned into H Pylori, but didn't figure that out for over 2 months, (and 40 pounds).
I said then I wouldn't do the second one, and after this is resolved I'll be glad I did it, but atm I am almost regretting even doing the second surgery. But cant dwell on that, I need to figure out what I need, to move forward and get past all this.
Thank you for your help!

REPLY

@artscaping
So I had PT and I saw my surgeon
as well this morning. Both tell me the burning pain is the nerves sort of firing back up and making connections again. In arthritic knees, the more bone they need to shave off for the implant the more pain a person can experience because of the amount of nerves and everything. It should resolve itself in a few weeks, or could be a few months.
I was afraid of my PT lagging because of this, but the PT said I'm doing good especially considering I'm still fresh and new. And I have to use ice, elevation, the pain meds on time, and work my exercises as I can tolerate so I can work past it. To be honest, they beat me up good at PT, but when I left i felt better. Probably the weight off my shoulders about progress helped.
I hope this can help anyone else who has this issue.
Any other things i may have missed that anyone wants to know from my POV please just ask.
Bluesquirrel

REPLY
@bluesquirrel

@artscaping
So I had PT and I saw my surgeon
as well this morning. Both tell me the burning pain is the nerves sort of firing back up and making connections again. In arthritic knees, the more bone they need to shave off for the implant the more pain a person can experience because of the amount of nerves and everything. It should resolve itself in a few weeks, or could be a few months.
I was afraid of my PT lagging because of this, but the PT said I'm doing good especially considering I'm still fresh and new. And I have to use ice, elevation, the pain meds on time, and work my exercises as I can tolerate so I can work past it. To be honest, they beat me up good at PT, but when I left i felt better. Probably the weight off my shoulders about progress helped.
I hope this can help anyone else who has this issue.
Any other things i may have missed that anyone wants to know from my POV please just ask.
Bluesquirrel

Jump to this post

Good evening @bluesquirrel. Thank your for sharing the results of your appointments with your PT and surgeon. Those comments will be read over and over again. I think another way to look at your situation is to say that the burning results from healing and rebuilding nerves and connective tissue. Nerves do regenerate but kind of take their own sweet time about doing it. I hope your burn situation dissipates quickly.

You know, saying that your PT beat you up pretty good is a difficult situation to tolerate and yet that is just the way the cookie crumbles. My PT knew that i was experiencing pain in order to build strength and stability. She thought it advisable to have my MFR therapist see me right after an exercise session to help with the pain and discomfort.

Do you know about Myofascial Release Therapy? I have been able to release the fluid that causes swelling and to work through the fascia restrictions that needed to be released to avoid pain. You can read about MFR on the John Barnes site at http://www.myofascialrelease.com. There is also a discussion on Connect. Let me find it.

Aha….here it is. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/. You can do some of the therapy movements yourself after experiencing MFR and asking your MFR therapist to show you how to do your homework.

Remember to be kind to yourself. I will be watching to read about your success now that you are your own advocate. Do you have stairs to manage in your home?

May you be free, safe, and protected from inner and outer harm.
Chris

REPLY
@bluesquirrel

@artscaping
I just typed up an answer and lost it, so I will try to get all info here again.
My medication started out with tylenol and oxycodone for pain and Celebrex for swelling.
I ended up in the ER 3 days after surgery for back pain (sciatica like) and got a shot of dilauted and a prescription for a few pills. That helped the pain immensely for a few days. I called my surgeons office and explained what was going on, they took me off dilauted and replaced it with a steroid pack which helped for the first day, but the second hadn't felt like it did anything (that is the day of original post).
I elevate quite a bit and also have the machine (cpm, or cpt ?) that moves my leg from straight to bent and do that as the PT said, 45 to 60 minutes 3x daily, or more if possible. I even sleep using it because otherwise pain is worse yet! I did tell PT about the burning and he did some pressure point thing that helped for most of that day, but did come back later.
I am not great with pain, and then I get in my head about falling behind with PT and hindering my progress, ugh!
My last TKR was a hot mess, the pain was bad then and the pain pills irritated my ulcers, which turned into H Pylori, but didn't figure that out for over 2 months, (and 40 pounds).
I said then I wouldn't do the second one, and after this is resolved I'll be glad I did it, but atm I am almost regretting even doing the second surgery. But cant dwell on that, I need to figure out what I need, to move forward and get past all this.
Thank you for your help!

Jump to this post

I read your post and can really feel for ya. I am almost 14 days out from my 4th TKR on the same knee. I too am experiencing that on-fire burning sensation. I had it with the other three surgeries but not as bad as this time.

When I discussed it with my new and greatly improved surgeon he said it's most likely from nerve damage. I had my shoulder replaced and experienced the same burning. I've been taking Gabapentin three times a day and it helps some. Pain meds do nothing for this type of pain, you've probably found that out. My situation is improving a little every day.

The only advice/encouragement I can
give you is to not give up. Hang-in with your P.T. and keep your knee moving. You will be successful if you don't quit.

All the best!

REPLY

I like everyone else always in search of finding ways to help my tkr recovery….I am over 7 weeks out first round of therapy did not help range of motion..,, when they told me just continue at home and I was only 65 and could not straighten my leg I thought I don’t think so…,. So I started water therapy and mfr I have been doing 3 weeks now my leg almost at 0 the bend still work in progress ..,. But I continue to look for answers …. I found interesting article about using tens unit in acl and tkr patients ….so yesterday I placed tens around my knee I wore for 8 hours so much easier to walk I did not have pain with ever step, exercise was less painful . I walked around store able to bend my knee with each step was nice …. I have done without tens i had pain with every step….I read the whole article makes so much sense for my case anyway so I will let you all know how it works. Hopefully in few weeks I will get my bend back here is the link if you want to read https://thebarbellphysio.com/case-study-quadriceps-inhibition-and-tens-post-knee-surgery/……this tkr recovery is a process for some of us and there is a lot of different methods out there I will keep trying because does not hurt to try

REPLY

Hello, I just read your comment on your second TKR….IM SO SORRY YOU HAVE TO GO THROUGH THIS.
I have a question for you. Are you or did you ever have allergy testing done before either of your TKR.?
I was never allergic in all my years (which is over 70). It was after my TKR that I found out I am allergic to neomycin (antibiotic) and methyl methacrylate ( this is the composite which holds the glue together! I found out normally, if you have a good doctor then.(he/she ) dr. should have sent you for allergy testing.. I’m 16 mo. Post operative, saw 9 drs! 2 were out of state, all due due to pain that I still The #9;dr. Suggested that I take an LTT blood test which, isn’t covered by insurance.
My Dr. Found out that I’m Not allergic to ANYTHING, that was inside my knee. But I am allergic to the methyl methyl me but, only topically!. It might give you some insight as to what’s going on for you. My dr. also sent me for an
MRI and he took x rays,
I wish you good health in your future. I hope I have given you some insight and something to think about as you move forward. Good luck on this journey!
Irish283

REPLY
@artscaping

Good evening @bluesquirrel. Thank your for sharing the results of your appointments with your PT and surgeon. Those comments will be read over and over again. I think another way to look at your situation is to say that the burning results from healing and rebuilding nerves and connective tissue. Nerves do regenerate but kind of take their own sweet time about doing it. I hope your burn situation dissipates quickly.

You know, saying that your PT beat you up pretty good is a difficult situation to tolerate and yet that is just the way the cookie crumbles. My PT knew that i was experiencing pain in order to build strength and stability. She thought it advisable to have my MFR therapist see me right after an exercise session to help with the pain and discomfort.

Do you know about Myofascial Release Therapy? I have been able to release the fluid that causes swelling and to work through the fascia restrictions that needed to be released to avoid pain. You can read about MFR on the John Barnes site at http://www.myofascialrelease.com. There is also a discussion on Connect. Let me find it.

Aha….here it is. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/. You can do some of the therapy movements yourself after experiencing MFR and asking your MFR therapist to show you how to do your homework.

Remember to be kind to yourself. I will be watching to read about your success now that you are your own advocate. Do you have stairs to manage in your home?

May you be free, safe, and protected from inner and outer harm.
Chris

Jump to this post

@artscaping
When I say the PT beat me up, its generally within reason to keep progress. It just feels so intense! But I know they arent there to cause harm. The PTs I deal with are all very nice and supportive and reassuring.
I will be looking into the Myofacial Realeae Therapy. Heck, I have some time to fill right now because the pain got so bad (the burning) yesterday that I was admitted to the hospital to get it under control. They are keeping me yet tonight.
The doctor said the lump in my leg is probably a hematoma and possibly pressing on a nerve, which is why the pain is so bad. I guess it will resolve itself. So far though the pain is better controlled. I had IV meds overnight, and now just oral meds so they can figure out the dosage and schedule I will need when I go home tomorrow.
I'll keep posting my adventure as I go.

REPLY
@4tkr

I read your post and can really feel for ya. I am almost 14 days out from my 4th TKR on the same knee. I too am experiencing that on-fire burning sensation. I had it with the other three surgeries but not as bad as this time.

When I discussed it with my new and greatly improved surgeon he said it's most likely from nerve damage. I had my shoulder replaced and experienced the same burning. I've been taking Gabapentin three times a day and it helps some. Pain meds do nothing for this type of pain, you've probably found that out. My situation is improving a little every day.

The only advice/encouragement I can
give you is to not give up. Hang-in with your P.T. and keep your knee moving. You will be successful if you don't quit.

All the best!

Jump to this post

@4tkr
I cant imagine having to go through 4 surgeries, especially on the same knee. I am so sorry to hear that! I hope it’s taken care of and you get back to “normal" soon.
As far as gabapenti goes, I am allergic to that medication so he tried using Elavil (?) but I only had that one night and that was the night before I ended up in the hospital so I’m not sure whether or not it would work for me.
Thanks for the encouragement! I have to keep moving forward, I've come this far so no turning back or giving up.
Thank you!

REPLY
@ezas123

I like everyone else always in search of finding ways to help my tkr recovery….I am over 7 weeks out first round of therapy did not help range of motion..,, when they told me just continue at home and I was only 65 and could not straighten my leg I thought I don’t think so…,. So I started water therapy and mfr I have been doing 3 weeks now my leg almost at 0 the bend still work in progress ..,. But I continue to look for answers …. I found interesting article about using tens unit in acl and tkr patients ….so yesterday I placed tens around my knee I wore for 8 hours so much easier to walk I did not have pain with ever step, exercise was less painful . I walked around store able to bend my knee with each step was nice …. I have done without tens i had pain with every step….I read the whole article makes so much sense for my case anyway so I will let you all know how it works. Hopefully in few weeks I will get my bend back here is the link if you want to read https://thebarbellphysio.com/case-study-quadriceps-inhibition-and-tens-post-knee-surgery/……this tkr recovery is a process for some of us and there is a lot of different methods out there I will keep trying because does not hurt to try

Jump to this post

I wondered if a tens unit would be beneficial, bit I'm always afraid to try something unless the doc says it would be ok. I see him Tuesday so maybe I'll ask him then. I've used it in the past for other things and its usually been benficial so it cant hurt to ask. Thanks for the suggestion.
When I'm not I the pain I was in, I do good. I was at 80 and 0 4 days after surgery, but with the pain and some added swelling that drastically dropped to I think 50.
I was hospitalized yesterday for the pain and I am now doing better, but cant go home until tomorrow. Still, I know i have to take this a day at a time and push myself a little, but not too much.

REPLY
@bluesquirrel

@4tkr
I cant imagine having to go through 4 surgeries, especially on the same knee. I am so sorry to hear that! I hope it’s taken care of and you get back to “normal" soon.
As far as gabapenti goes, I am allergic to that medication so he tried using Elavil (?) but I only had that one night and that was the night before I ended up in the hospital so I’m not sure whether or not it would work for me.
Thanks for the encouragement! I have to keep moving forward, I've come this far so no turning back or giving up.
Thank you!

Jump to this post

Great attitude. Thank you for your reply.

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REPLY
@irish283

Hello, I just read your comment on your second TKR….IM SO SORRY YOU HAVE TO GO THROUGH THIS.
I have a question for you. Are you or did you ever have allergy testing done before either of your TKR.?
I was never allergic in all my years (which is over 70). It was after my TKR that I found out I am allergic to neomycin (antibiotic) and methyl methacrylate ( this is the composite which holds the glue together! I found out normally, if you have a good doctor then.(he/she ) dr. should have sent you for allergy testing.. I’m 16 mo. Post operative, saw 9 drs! 2 were out of state, all due due to pain that I still The #9;dr. Suggested that I take an LTT blood test which, isn’t covered by insurance.
My Dr. Found out that I’m Not allergic to ANYTHING, that was inside my knee. But I am allergic to the methyl methyl me but, only topically!. It might give you some insight as to what’s going on for you. My dr. also sent me for an
MRI and he took x rays,
I wish you good health in your future. I hope I have given you some insight and something to think about as you move forward. Good luck on this journey!
Irish283

Jump to this post

@irish283
Hello, thanks for contributing to my question.
I have never done any type of allergy test. That did go through my head though, with a panic, what would happen if that were the case? Ugh!
I had an xray right after the surgery, or I was hallucinating that they did that lol! But I go Tuesday for my post op and get xrays then. So far everyone has said the joint seems to be good. I think it’s this lump that appeared on the inside. Doc said it’s a hematoma and probably pressing on a nerve which causes the pain. He isnt concerned about it though, so I’m trying to not worry about that either.
(It’s just a strange and solid and sensitive lump)
Thanks again! All ideas and insight are very appreciated!

REPLY
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