TKR Deep pain

[Annieamersham]

I had a TKR 3rd October last year. I am still suffering immensely with pain. I can walk well but not without feeling pain with every step. I get lots of zaps of pain which take my breath away. This happens a lot in the night as well. Is this normal? How much longer can I expect it to go on? I'm wondering if I have an infection in my knee somewhere although it is not very swollen.

 

[Layla]

Hello and Welcome to BoneSmart and recovery. Thanks for joining us.

You are only a little over four months into a recovery that can last a full year for most and even longer for others. I am wondering if you've been icing and elevating since your surgery? I am assuming you're dealing with swelling since you mentioned "it is not very swollen".

Also, wondering if you are engaging in any Physical Therapy that could be contributing to the pain you describe. Have you shared this pain with your surgeon at any post op visits, and if so, what was the conclusion? Possibly another visit is in order for some reassurance from your OS. There are many odd sensations that go along with the healing process and as nerves regenerate there are zings and zaps, but deep pain with each step should probably be evaluated

Please share which knee you had replaced and we'll create a signature for you. Also, if you have any questions after reading the Recovery Guidelines, please let us know and we'll do our best to advise. Do consider touching base with your surgeon and please keep us in the loop. We're here for support always. I wish you comfort and perfect healing.

 

[Layla]

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

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 a 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 history before providing advice.

 

[sistersinhim]

I get lots of zaps of pain which take my breath away. This happens a lot in the night as well. Is this normal?

Those zaps of pain are completely normal. We call them zingers. They are your nerves reattaching, rerouting, and/or healing. I would have them so badly that sometimes my leg would actually jump up off of the bed. No fun at all. Just know that it's all part of the healing process and they will soon be less intense and then go away. Some members have found that gabapentin helped them, but this is something you need to discuss with your doctor.

 

[Annieamersham]

What an amazing forum. Thank you so much for the reassurance. I was really worried about the (Zingers) but now you've explained them I feel much happier.

 

[Annieamersham]

Thank you so much for your very informative reply to my questions about my right knee TKR. I feel very encouraged and will start re icing which I had stopped doing. Also I will restart taking my pain killers regularly rather than waiting until I get bad pain. I am currently out of the country until 22nd March and cannot therefore see my OS until the 24th to talk about the deep pain which I get (sometmes) while walking. However today I have done over 7000 steps so far with very little pain. Perhaps I just needed some reassurance. Thank you once again for your help.

 

[Jaycey]

Well done - sounds like you are back on track with this recovery. Your strategy of icing and taking your medication will really help.

Please keep us updated on your progress.

 

[Annieamersham]

Thank you. Yes I will keep you updated on my progress.

 

[beachy]

My doc prescribed Gabapentin for nerve pain aka zingers. I also took it 2 yrs ago when I had shingles. From what I understand it helps with nerve pain. If you can't handle the zingers call your doc to see if he can prescribe the gabapentin or something else.

 

[beachy]

PS....I haven't experienced any nerve pain .

 

[Annieamersham]

Lucky you. I get lots of Zingers mainly at night when I am trying to sleep. Also I get more general knee pain at night than i get during the day. Is this normal ?

 

[Annieamersham]

I'm not sure if I put that message in the right place. I'm pretty useless with technology. Sorry.

 

[Layla]

Hi there,
Yes you did post in the right place.

Zingers are common, Annieamersham
While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process.

Possibly you are noticing more pain at night depending upon your activity level during the day. Pain is also more noticeable when we're not busy or preoccupied with our daily routine. It's not too late to ice at night while you're relaxing and watching tv or reading, try it and see if it brings you relief. Remember also that your body is still healing at only 4.5 months post op, in a recovery that can last a full year for most and even longer for others.
Take good care and stay in touch!
@Annieamersham

 

[EalingGran]

had a TKR 3rd October last year. I am still suffering immensely with pain. I can walk well but not without feeling pain with every step. I get lots of zaps of pain which take my breath away. This happens a

As others have said Zingers are normal and a sign of healing but miserable- especially at night.
I am not sure though if immense pain with every step sounds normal.
I had a pkr later in the same month as you and I can walk with minimal discomfort for a good distance ( up to 3 miles with a break to rest). I would definitely talk to your doctor if I were you.

 

[Annieamersham]

Thank you. My pain on walking is definitely getting less so I think I'm well on the way to getting better. If only the night pain would ease up I'd be a very happy bunny.

 

[Annieamersham]

Thank you. I am currently on holiday and am doing lots of walking so maybe a bit too much. It is definitely improving though so I am feeling more hopeful for a full recovery soon. I was feeling very depressed when I first contacted Bonesmart and am much more positive now. So thank you for your help and advice.

 

[Layla]

Aww, that is great news that you're feeling more positive. Enjoy your holiday and be careful not to over do it.
Don't forget about ice if you feel like you pushed it a little too much.
@Annieamersham

 

[Annieamersham]

I think I overdid the walking on Sunday when I did over 12000 steps. My knee is swollen and painful and I feel I have gone backwards. I am icing it often but the swelling and pain are still there. Hopefully it will settle soon.

 

[sistersinhim]

Oh yes, you definitely overdid! Don't forget to elevate your toes above your heart at the same time you are icing. You can also ice all day long as long as you have a cloth between you and the ice source.

 

[Annieamersham]

I'm not sure if I put that message in the right place. I'm pretty useless with technology. Sorry.

Knee still painful and swollen so I'm not walking as much. Disappointing as it seems I've gone backwards with my recovery. I'm possibly not icing enough so I will start doing it more often. Thank you for your advice.