TKR 2 years on and in more pain than before I had the surgery<

[Josephine]

Joey, you were certainly NOT a moaning minnie! This is what this forum is for, for people to vent about seemingly unending issues.

So now, having merged your threads (for the 5th time!) and read your thread all though, I will need to ask you some questions. I actually posted these twice before and though the second time you said you would answer them, you never did. So can I ask them again? Will it be third time lucky?

I'd also like you to tell me where your pain is

 

[joey5898]

Hi Josephine, my pain is mainly in the centre of my new knee, back and front but pain radiating up and down the whole leg. Severe pain in my lower back too

 

[joey5898]

Cant see any of your other questions ??

 

[sistersinhim]

@joey5898 will you look at the chart that Josephine left for you and point out exactly where your pain is? That will help her to narrow it down for you and try and get your some help.

 

[joey5898]

RF1 ABCDEFGH
RB2 ABCDEFGH

the whole leg xxx

 

[sistersinhim]

OK, I understand. @Josephine will be back with you when she can.

 

[sfnative]

Though I've only read your initial post, I do hope you're doing better - a lot better. Quite frankly, I must tell you that what you were ordered to do sounded exactly what I was given as goals post-op L5-S1 fusion! I had a TKA left knee due to having developed a valgus knee and PT was vigorous. Though encouraged to walk, the idea was to get vertical, keep the joint moving at home and not just sit and vegetate 24/7.

 

[joey5898]

@Josephine I often wonder if the epidural I had in the spine at my TKR has something to do with my chronic back pain. He struggled to get the needle in, took a number of attempts.

 

[Josephine]

RF1 ABCDEFGH
RB2 ABCDEFGH
the whole leg xxx

Ooh ouch!

I often wonder if the epidural I had in the spine at my TKR has something to do with my chronic back pain. He struggled to get the needle in, took a number of attempts.

Well that's something to consider. I'll bear it in mind.

Cant see any of your other questions ??

No, fraid I never left them. I usually ask people first!

But here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine.Don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. are you taking any pain medications? If so, what, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you still icing your knee at all? If so, how often and for how long?

6. are you still elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[joey5898]

Hi @Josephine
Below are my answers to your questions but bear in mind these incorporate BOTH knees, new and old, whole leg of the RTKR and lower back.
1) pain level is 8 both knees and right leg and up to 9 in lower back
2) co-codamol 30/500 mg x 2 at bedtime
Nurofen 256 mg x 2 every 4-6 hours throughout the day
3) swelling is moderate
4) ROM 120 when physio last measured a year ago but still struggle to bend to do normal tasks like getting dressed, getting into and out of bath, kneeling is agony.
5) icing when get into bed at night for half hour
6) Elevating every chance I get during working day or when pain gets too bad (back is main problem here)
7) do all daily chores (albeit painfully!) and work at Police Station, Front Counter Officer.
8) Exercises - try to swim twice a week for 45 mins. Exercise bike at home 3-4 times per week 20 mins. No longer have Physio.
Have sadly piled on the weight over the last 2 years which doesn't help I know.

 

[bill 3/20]

I am not as far along as you, but have been troubled with severe lower back pain since shortly after surgery. In addition to pain Meds, I got some relief from massage, acupuncture, and chiropractic, but pain persisted. I am not pain free yet, but think I am resolving the problem by using the following stretching DVD:

I used to use it years ago. It's very gentle, and is working wonders for my pain. I have never been a flexible person. This is not yoga. I find the video helps because if I do it, I hold the stretches long enough.

Best wishes.

 

[joey5898]

Hi Bill 3/20 , I'm interested in any suggestions, I'll check out the DVD on Amazon UK, thanks very much, very kind of you.
Joey x

 

[Josephine]

1) pain level is 8 both knees and right leg and up to 9 in lower back

Hmm - so your left knee is also in need of replacement, yes?

2) co-codamol 30/500 mg x 2 at bedtime
Nurofen 256 mg x 2 every 4-6 hours throughout the day

If you have so much pain, why are you on;y taking co-codamol once a day? And why are you taking Nurofen (ibuprofen)? It's not a very good pain killer and has considerable and serious side effects. Medications: paracetamol and NSAIDs, differences and dangers.
You'd be much better of and safer if you took 2 paracetamol 4 times a day instead,

3) swelling is moderate

Okay

4) ROM 120 when physio last measured a year ago but still struggle to bend to do normal tasks like getting dressed, getting into and out of bath, kneeling is agony.

Oh dear, that's not good is it? Would you like me to measure your ROM again? If you can send me a photo of your leg in one of these positions, I can easily do it. As for extension, you can assess that yourself as per here Extension: how to estimate it

5) icing when get into bed at night for half hour

Never during the day? And you accomplish little or nothing in 30 minutes. Ice for at least 40-60mins for best effect.

6) Elevating every chance I get during working day or when pain gets too bad (back is main problem here)

Okay

7) do all daily chores (albeit painfully!) and work at Police Station, Front Counter Officer.

Are you full or part time? And do you have to stand all day or can you sit some of the time?

8) Exercises - try to swim twice a week for 45mins. Exercise bike at home 3-4 times per week 20mins. No longer have physio.

Why are you still doing all this? Is it for your right knee?

So sorry, your answers have just generated more questions!

 

[joey5898]

Hi @Josephine
1) Yep, I do think the other knee needs doing but there's no way I'm going there yet!

2) I take co-codamol at bedtime as it gives me about 4 hours sleep, I can't take it through the day as it sends me to sleep big time. I know what you mean about upsetting my tummy with certain types of painkiller (if you recall I was in a bad way last spring 2016 when I had diarrhoea for 3 months after being on Naproxen for months, stopped the naproxen and it cleared up. (They checked the bowel and thankfully that was fine) I take UK Nurofen Back and Joint through the day as it works very well but you're right, it's so bad for me and I must admit I'm beginning to feel ill again, bowel movements changing. I've not taken any this morning, just paracetamol as you suggest.

3) I think my ROM is better than 120 now but it's just when I weightbear it feels very stiff and hurts if I try to bend beyond its capability.

4) I think I ice when I get in bed out of habit, it soothes and cools the knee before I go to sleep. I'll try and do it through the day too.

5) I've just gone part time at work as couldn't do the full shifts any longer, could hardly crawl to my car at the end of 9 hours! I'm up and down all day, at counter then back to my desk many times, can be stood for 30 minutes at counter depending on what I'm dealing with but if I sit too long at my computer I stiffen up and back and knee is agony.

6) I try to swim and exercise bike to deal with the massive weight gain. I believe because I can't walk far now and move so much slower and do a lot less activities are some of the reasons I've gained so much. I feel so unfit, used to be quite active before the OP. And so miserable I comfort eat !!

Joey xxxx

 

[Josephine]

I know what you mean about upsetting my tummy with certain types of painkiller. I take UK Nurofen Back and Joint through the day as it works very well but you're right, it's so bad for me and I must admit I'm beginning to feel ill again

(Honey, I'm in the UK too so no need to define it!) But did you know, these NSAIDs which are described as targeting a specific site are all baloney? No matter what type you use, they all treat the entire body no matter what! Also, by buying a brand name like Nurofen you are paying sometimes 150% more than the generic type of ibuprofen which you can buy almost anywhere.

I know what you mean about the co-codamol - or rather the codeine in it. If I take it just once, I can sleep for the Olympics and am block up for at least two days! Is the paracetamol helping at all?

bowel movements changing

For the good, I trust?

Otherwise, swimming is good to keep you limber but do watch that comfort eating!

 

[joey5898]

Hi @Josephine , I know what you mean about the rip off techniques of the drug companies but maybe all in my mind but those back and Joint Nurofen do seem to help the back pain more than others I've tried but they are so expensive like you say. I've made an appointment with my GP for next week to discuss the pain I'm in. I've taken paracetamol this morning and just now instead of Nurofen as you suggested, pain not too bad as it's my day off today so am able to take it easy.

 

[joey5898]

My bowel movements are changing for the worse because I know I'm taking too much ibuprofen. I will try and keep off them and I'm sure my bowels will appreciate that

 

[Josephine]

I know I'm taking too much ibuprofen. I will try and keep off them and I'm sure my bowels will appreciate that

NSAIDs don't cause such bowel problems. It's not the bowel they affect, it's the upper GI tract, the lower end of the oesophagus, the stomach and the duodenum.