TKR Lots of Post-Op Pain

Sylph

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I had TKR on April 27, 2022 and it is now 6 days later. I’m feeling very emotional and waking up crying multiple times a night in pain. Finding this forum is a life saver.

I have my parents and the PT pushing me to walk, walk, walk, stretch and bend as hard as I can. So I have had a lot of swelling and muscle spasms. I knew intuitively that this was counterproductive but I had no information to back me up so I was giving into the pressure every day and spending my nights crying from the pain.

I have good extension and decent flexion. But thank God I found you all before they destroyed my knee.

Thank you for being here. It means so much to me.
 

Jockette

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Hi and Welcome!

You are correct, they are all pushing you too hard. It is counterproductive to increase your pain level, at any time, but especially at only 6 days after this surgery. Follow your instincts and your common sense and do your recovery the way you think you should.
Saying no to therapy - am I allowed to?

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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.
 

Jamie

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Hi, @Sylph We're glad you've joined our community and it's good to hear that you've found information here to help you with your recovery. Good for you that you instinctively knew you have been pushing yourself too much too soon. Please read through our information contained in the links labeled Postop Care in the blue toolbar at the top of the page to better understand exactly how healing takes place. Also, I hope you can read through the information that Jockette has provided for you above. It will help you.

I've created a signature for you in your profile but I'd like to add which knee you've had replaced. Please post if it was the right or left knee.

Movement is important after joint replacement, but it needs to be done in a common sense way. Any pain you experience with your daily bends and stretches or with therapy exercises should only create mild discomfort....certainly not serious pain. When you go beyond the discomfort level, it is possible to irritate tender tissues that are trying to heal. The constant state of inflammation can actually be counterproductive to recovery. It's the same with walking. You need to walk a bit every couple of hours each day, but doing more is not necessarily better.

The first order of business for you is to get your pain under control. It's okay to stop doing all the exercises, walking, and activity for a while until this takes place. This does not mean you become a couch potato. It just means you take a more gentle approach to the movement you do with your knee during the day.

Take some type of pain medication (either your prescription provided by your doctor or Extra Strength Tylenol) on a set schedule throughout the day and night so that medicine is in your body at all times. If your choose Tylenol, be sure not to take more than 1000 mg at a time and do not exceed 4000mg in any 24 hour period. You also need to count any acetaminophen in other products like cold and sinus medication in that 4000mg total. If you cannot get your pain controlled, your surgeon needs to know you're having a problem with this.

If you choose to continue with your therapist, make it plain that what has been done is not working and you will not do any exercises that result in the pain you've been experiencing. You have that right. The therapist works for you.

Your knee will not "freeze up." You are merely allowing it to recover from this period of overdoing things. Once the pain is under control you can begin to add in additional activity and exercises slowly and gradually. Your body will tell you when or if you've overdone things. At that point, you just scale back for a day or so and then start again. Through this time, it is important that you move your knee on a regular basis. This means bends and stretches where you take yourself just to the point where the discomfort starts and hold for a while. Or you can walk about the house for 5 minutes or so. It's important to do these gentle movements every couple of hours each day.

Rest your knee with ice and elevation as much as you can. You can ice overnight while sleeping if that is comfortable for you. Just be sure to always keep a towel between you and your ice source so that skin is not damaged.

You may need to be firm with your therapist and your family. You are doing the right thing by listening to your body. Remind them that this is your recovery, you know your body better than anyone, and you need to do this your way.

Good luck and let us know how you're doing.
 

Jamie

OneStep AMBASSADOR ..Staff member since Feb 2009..
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One other thing....when I created your recovery thread, I gave it a title for you. But if you'd like to change it at any time, just post what you'd like here and one of the staff will do that for you.
 

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