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  1. PLEASE NOTE THAT ONE RECOVERY THREAD ONLY IS PREFERRED. PLEASE DON'T START ADDITIONAL THREADS ABOUT YOUR RECOVERY.

Muscle Spasms causing involuntary flexion at night

Discussion in 'Knee Replacement Recovery Area' started by cdlights, Apr 26, 2011.

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  1. cdlights

    cdlights Junior Member

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    I am at 6 months post my right TKR. Progress has been really slow despite a great doctor and good physical therapy. My flexion seem to be pretty stuck and I am just living life as best I can. Biggest problem for now is that I am awakened in the night with a VERY painful flexion/spasm of my knee which seems to "clamp it down" way past my waking flexion range. This is much worse then any pain though this TKR recovery process. My doctor is stumped, has not had a patient have this experience before and has tried several different types of muscle relaxers with no success. The incident continues to happen almost nightly and sometimes several times in the night. I am awakened screaming and that scares everyone in the house......I am pretty tough so this pain is really extreme. I am becoming terrified of falling asleep and that is not good for the healing process. I try heat, ice, stretching and anything else I can think of. I would SO APPRECIATE hearing if anyone else in recovery has had this experience and, if so, did anything help. I am still two months away from having a MUA based on my doctors time frame. I am not sure I can make it that long with this. Thanks in advance for ANY input!

    Danny (female Danny!)
    LTKR 10-28-10
  2. carousel66

    carousel66 Graduate

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    I'm sure others will have suggestions, but the only thing I can equate this to is something I suffered with PROIR to my TKR. My "good" leg was doing so much extra work I had some very bad spasms in my IT band and general just horrible pain for the overwork the "good" leg was doing. I tried several things my doc dx but what did the trick was a VERY good massage therapist getting at the root of some very unhappy muscles and a very unhappy IT band.
    might be something to consider?
    welcome to Bonesmart!
  3. cdlights

    cdlights Junior Member

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    Thanks for replying......don't know what the IT band is, sorry!! I am desperate here so I will give some massage therapy a try. Just is the strangest sensation and feels like someone is literally breaking my leg. I straighten it after and it stops the pain although it remains very sore. I welcome all suggestions!!
  4. Jamie

    Jamie Administrator

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    Hi, cdlights....welcome to BoneSmart! I'm glad you joined us, but very sorry to hear you are hurting like this. I'm going to tag our forum nurse, Josephine, so that she can comment on what you have posted. Your situation seems quite different from the "restless legs" that can be common with knee replacement recovery. @Josephine:

    In the meantime, here is a link to the Library article regarding IT Band problems. You also might want to spend some time reading other threads in the Library....lots of good information there.

    You might try a heating pad on the small of your back all night. Also, you could try drinking 8 ounces of good Tonic Water (like Canada Dry) at bedtime...be sure it has real quinine in it. The massage idea sounds good also.
  5. cdlights

    cdlights Junior Member

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    Thanks so much Jamie! I am desperate! I will check out you links and hope to hear from Josephine as well. I knew I had found the right spot to ask for help. Again....... THANK YOU!
  6. Pilarknee

    Pilarknee Member

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    Hello cdlights. My mom who is nearly three months has suffered also a very sharp pain in the back of the knee, particularly in the hamstring, which seems to be a muscular or tendon and which only was at night.

    Now after almost three months of being awaken every night by that kind of pain, this has been decreased. She used muscle relaxers, and also made stretches. The doctor told her that this was due to the fact that after surgery the leg has been staightened, so it takes a whie for those muscles to adapt.

    Surely our forum nurse Josephine will give you a better answer, and she told my mom also that it would be a good idea to go see a chiropractor for a deep massage of the zone.
    Hope you feel better shortly.
  7. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    And just what I am going to recommend again, Pilar! Chiropractors use a form of acu-pressure which gets the muscle spasm to ease off. Often the muscles that are involved are in a constant state of spasm even though you think there are periods when it's not so bad. A good chiropractor will quickly be able to see this and know exactly where your problems are coming from. So I do urge you to try it out.

    Interesting though, how doctors tend to reach for the pills instead of actual treatment! Oy!
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  8. maryo52

    maryo52 Sr Bonesmartie

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    cdlights

    I too wish to welcome you to this very supportive forum. You present a unique problem.

    Thinking out loud . . . I too had MUA. Not sure the reason for your doctor's timeline on that since scar tissue tends to get tougher over time. But perhaps he's conservative and that can be a good thing. So I'm guessing you have a flexion issue.

    If you do have limited flexion, I imagine PT is trying to get more flexion. I know in my case with scar tissue, the more PT tried to gain me flexion, the more I suffered (which made me hurt at night but not have sudden cramping). I'm just thinking through this and wondering if something that's happening in PT is coming back to bite you at night. Might you try a few days rest from any physical therapy (from PT or self) to see how that affects your nighttime issue?

    I hope you find relief soon!
  9. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    I forgot to address that!

    May I ask why he is doing an MUA on a schedule? It seems a bit bizarre to me.
  10. maryo52

    maryo52 Sr Bonesmartie

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    Some more info might help us help you . . .

    Which muscles exactly are going into spasm at night?

    What is your PT routine?

    I know that flexion efforts before I had adhesions arthroscopically removed pulled on my joint capsule, which my OS said is nerve-rich, and HURT. If I had had a charlie horse in my calf muscle at night during that time, which yanks my leg into flexion, I too would've cried out. Just a theory.
  11. cdlights

    cdlights Junior Member

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    Gosh.....thanks for all the kind replys.
    Josephine- My Dr (who happens to be my daughter in laws dad) has been our ortho guy for many years. He is clear from the beginning of this process that he has some different approaches then I might find on line.....such as his belief in waiting to at least 8 months for a MUA, he actually has the best luck at 1 year. He finds those done earlier retain very little gain, and the longer he waits the more flexion the patient retains. He has done tons of TKR's and many on friends of ours, mine just has been a bear for him and for me!

    I have to run but will check back as soon as I am able this evening and address the other questions. Thank you ALL for trying to help me find an answer of sorts to this very odd and painful circumstance!
  12. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    So are you saying all his TKRs get MUAs at 8 months regardless? :scratch:
  13. cdlights

    cdlights Junior Member

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    No, not at all! Just not before that. They rarely get done at all. If he. Does do one he finds them to be most helpful at 8 months or longer. Writing this on a mobile device now so hope it comes through!
  14. Josephine

    Josephine Forum Admin and Mother Hen Administrator

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    Oh phew! That's all right then!
  15. brs0660

    brs0660 Forum Advisor

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    I may be hallucinating...but might low potassium or calcium cause these kind of spasms? And did I not read recently that some docs are using Lyrica to treat some of these pains???? @Jamie:
  16. Jamie

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    You are right, Barb, that muscle spasms can be a symptom of problems with both potassium and blood calcium levels. Thanks for mentioning that.

    Danny.....since this is a possibility, if you haven't done so it probably would be a good idea to have your GP run a series of blood tests just to rule out some type of imbalance in your system first.

    I feel like if it was an imbalance, you'd have the cramps or spasms at other times during the day also, but it might be best to just do the tests to make sure this isn't all or part of your problem.
  17. cdlights

    cdlights Junior Member

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    I was taken out of PT as they felt that after 3 months it was just keeping my knee so"angry" as Mary described above. I run a ranch so I get lots of walking in each day. I stretch and rest as well.
    I have tried massage, ice, vitamin e, muscle relaxers, heat pads, heat wraps, calcium, potassium..... Yikes I feel I have tried so much. I saw a post on another site and a concerned wife had written in about her husband suffering my exact symptoms. The advice given was that they talk to their surgeon! That is the only post I have ever seen which describes what I experience. Each occurrence is like a MUA but with no A! I take pain pills before bed but nothing is strong enough when this hits. I will talk to our chiropractor and see what he can do for massage. I am open to anything!! I think until the adhesions break loose, or are broken with the MUA this may be a fact of my life. I just hope not. Thanks for the help...... All additional thoughts much appreciated!
  18. sashayinglady

    sashayinglady Senior

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    Welcome, cdlights! I understand your problem, sometimes I awaken and both of my knees have flexed so tight that I have to slowly stretch my legs out and perform heel slides & leg lifts. I do have an IT Band issue in my right leg, massage/heat does relax it and decreases the discomfort. I do take Skelaxin at bedtime, been on that med for years. Have you tried CoQ10 supplements for muscle spasms, especially if you are taking a Cholesterol medication ( Statin )..just a thought since I don't know your medical history. Since I'm working my 12 hr night shifts, I can tell you when you're on your feet too much, your muscles tighten more frequently, so maybe you're walking the ranch too much. I've learned the hard way, so please rest & relax , elevate above your heart & checkout the helpful hints that Josephine has posted, full of valuable info that may eleviate your concerns/fears. You will have good and bad days, but it does get better:prayer1:
    Darlene:doggieshmooze:
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  19. cdlights

    cdlights Junior Member

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    Thanks for the ideas, help and support. Last night was a bad one, two separate episodes 2 AM and again at 4 AM. I was sleeping with a heating pad but it still was an especially extreme episode. I am CONVINCED each time this happens some lesions are broken loose as I have slightly better flexion the following day althouh the knee is always very sore. I am once again dreading going to sleep.
  20. Jamie

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    I'm so sorry.....I know this must be very frustrating to you. Have you been able to find a chiropractor?
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