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[TKR] Back pain when sitting

Discussion in 'Knee Replacement Recovery Area' started by vlambert, Jun 13, 2019 at 5:57 AM.

  1. vlambert

    vlambert new member
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    Hope someone has some suggestions for me.

    Had a TKR on Thursday June 6. One thing I was not prepared for is I can’t get comfortable in a chair. I have a sofa with an ottoman and get home from hospital and sat in that chair for a bit and it made my lower back hurt. So went back to bed and back got better - then tried a different chair and same problem. Changed chairs to eat dinner at the dining table and did a bit better (though my leg is down for the meal).

    Just need to know if anyone else has had this issue and if I should buy a recliner. I have tried putting a lot of pillows behind my back when on the sofa but so far does not really help.

    I have had back surgery and I know that the back pain is from sitting “wrong” without the right support. I have a “flex” bed so can get comfortable there. Just scared if my back goes out completely that will put me way back.

    I did a LOT getting ready for the procedure (22 years ago my Dad died after TKR). Bought the ice packs, borrowed a therapy ice machine, got the shower chair, removed the rugs, got a knee buddy pillow, moved a computer and set up so I could work out of my house for a while, bought a recumbent stationary bike, etc. Even did one session with therapist before surgery to make sure I was on track and doing everything I could for a positive outcome.

    Had three months to prepare as I had an injection and had to wait three months for surgery. My knee after the injection was not really painful at all so I did all the exercises and was even biking 6 miles per day.

    If anyone can give me suggestions. Just want to be able to concentrate on the knee and not worry about the back.
     
  2. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi and Welcome to Bonesmart!

    I have back issues, too, and I totally understand what you are going through. My back is very uncomfortable if my leg is stretched out at the same level as my hip. (like if I was sitting on the floor) For me, my ottoman is just a little lower than my couch, and it’s comfortable. It is not the ideal level of elevation, but it worked for me when I was not in bed. Any time I was in bed, my leg was properly elevated on my foam wedge.

    You just have to experiment to find what works for you. I was very compliant my first month post op but right away refused to do anything that was not in my back’s best interest, as it took a long time to get it to a manageable level.

    Also, you don’t have to keep your leg totally straight, a slight bend will be more comfortable and won’t do any harm to your knee.

    I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

    We do have an article about elevating which is excellent, but you may have to tweak it a bit to find your comfort zone.

    Knee Recovery: The Guidelines
    1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
    2. Control discomfort:
    rest
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork.
    3. Do what you want to do BUT
    a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
    b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
    4. PT or exercise can be useful BUT take note of these
    5. At week 4 and after you should follow this
    6. Access to these pages on the website

    The Recovery articles:
    The importance of managing pain after a TKR and the pain chart
    Swollen and stiff knee: what causes it?

    Energy drain for TKRs

    Elevation is the key

    Ice to control pain and swelling

    Heel slides and how to do them properly

    Chart representation of TKR recovery

    Healing: how long does it take?

    Post op blues is a reality - be prepared for it
    Sleep deprivation is pretty much inevitable - but what causes it?

    There are also some cautionary articles here
    Myth busting: no pain, no gain
    Myth busting: the "window of opportunity" in TKR
    Myth busting: on getting addicted to pain meds

    We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

    While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
     
  3. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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    @vlambert
    Welcome to BoneSmart, glad you joined us!
    A recliner chair may help, you may be able to rent, or purchase a used one. Suggest you try one out before purchasing.
    Here are some tips about purchasing a recliner chair.
    Recliner chairs: things you need to know if buying one for your recovery.

    Since the dining room chair (usually firmer) is more comfortable suggest you sit there, you can try putting your leg up on another chair or ottoman of some sort.

    If you are being seen by OT or PT they should be able to help you with setting up a more comfortable seating environment.
     
  4. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    Have you tried a heating pad on your back?
     
  5. Tmgrl3

    Tmgrl3 junior member

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    Hi viambert,

    Welcome

    I too have back problems and have for 40 years. All my vertebrae are herniated or stenosis. I also have radiculopathy and neuropathy, with some of this from severe nerve compression at L5-S1. My surgery is 11 weeks ago today. My first 10 weeks were a time of insomnia and of inability to get comfortable almost anywhere. By night my feet and ankles often were burning and hurt as bad or worse than my knees. I was told to ride out these early weeks, since everything is affected by the TKR. The bundles of nerves from the back run down backs and sides of legs.

    I had bilateral knee replacements so was literally stuck on my back until about two weeks ago and no place was comfortable. I was only on tramadol 50 for pain for first four weeks and as knee pain got better, stopped the tramadol, but my sleep got worse as my activity increased...so a week ago I went back on tramadol just at bedtime.

    My recliner was always the most comfortable chair but it made my feet and ankles worse. Best was a club chair with an ottoman. Raising my legs on pillows was the worst. So you have to find what will work for you but actually you are only a few days into recovery and nothing feels right and everything seems to hurt.

    The suggestion to rent a recliner is good. We rented one for two months for my husband who had a triple lumbar fusion September 5. Nine months out now and he can sit anywhere, but for first two months, the recliner that raised up to standing position electrically and then lowered was only place he could sit.

    Also, remember, your pain medication protocol is meant for “pain” not just in your knees but for other areas the surgery affects.

    Last night after 10 weeks of mostly 4-6 hours of sleep a night I slept for 9 hours. I went back on tramadol 50 a week ago, just at bedtime. With Tylenol and I started to get some real sleep since I had no position in bed that didn’t hurt by time I went to bed.

    I have had great knee healing. 130degrees flextime, could stretch both legs out flat by second week, have been walking without even a cane for weeks now...almost feels like I didn’t have knee replacements til evening approaches.

    I am 76 so overall healing probably a bit slower. Also, in the hospital I had four blood transfusions in two days because of blood loss. This whole healing thing is trial and error, up and down and one of searching for a few hours a day in the beginning where you can get comfortable and of taking the meds you need to get sleep. Sleep is critical to all of it. I had terrible depression, 32 pounds of edema in the two legs, and since then lost all of that plus another 8 pounds because of no appetite and intermittent nausea.

    So...Your back doesn’t know what to do right now and you just have to try things. Heating pad in am is a must for me. Also middle of the day and when I do my final knee icing at night I also ice my back. Gradually the back, feet and ankles are getting better. I have a pillow in the recliner with another towel roll to put behind my head so I can sit in family room and watch tv. This chair used to be my best seating.

    Just hang in there, take your pain meds now. Don’t be a hero. Remember we tighten up from severe pain, all over and pre-existing issues come into play. You will get better!!! I was so proud I had stopped the tramadol just a month in and then let myself suffer every night not sleeping enough.

    Keep us posted. Wishing you good recovery. Patience and trial and error and toleration of the good and bad days as being normal are the key...rest and don’t rush it. At ten weeks I can see the light at the end of the bilateral knee replacement tunnel.
     
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  6. vlambert

    vlambert new member
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    Thank you so much! I bought a recliner and it helps so much. Tried sleeping in the bed again and have decided I am going to stick to the recliner for a while. It is MUCH better. I only had one knee done and feel like such a wuss.

    I was doing the pain meds (Tylenol with hydrocodone 7.5 ) every 4 hours like the script says (every 4-6 hours). I was doing really pretty good those first few days and then my Dr’s nurse told me I was taking way too much (this was on day 5 after surgery) and they would not refill. She made me feel like a drug addict. She said I had better back down to every 5-6 hours. So it has been hard.

    So glad to know that there will be a light at the end of the tunnel. I am on day 10 post surgery. You are amazing having two done at once and doing so well.
     
  7. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    That is so mean, treating you like a drug addict, telling you that you can’t take your pain medication as it was written. Goodness, it’s not like you took more than you were supposed to.

    I’m so sorry this is how patients are being treated.
     
  8. vlambert

    vlambert new member
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    Me too. But I am sort of figuring out pain med then three hour Tylenol then three hour pain med and so on. I am hoping that will help.
     
  9. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I am going to tag @Josephine,
    our forum administrator and nurse director, to come and talk to you.
     
  10. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     

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