TKR new knee feb 21 and a question

[backwater]

I'm from Iowa and first joint replacement on left knee. I'm having severe knee spasms that last 10 seconds or so and this happens quite often when laying down. It's in the knee and feels like it's contracting and shakes like crazy and painful. The dr changed pain meds to oxycodone. This helps if i take 2 before bed mostly but still happens maybe depending on my activity that day. It sets me back because the knee is very sore and stiff. I had meniscus surgery twice before and had twitching a few weeks after in the same area afterwards the last time. But that was like a short twitching with no pain. Now it's a very painful violent shaking and twice a kicking reflex. Only relief is sitting up and waiting for meds to catch up or taking another and waiting for that to kick in. Anyone know what's going on? thanks

 

[Jockette]

Hi and Welcome!

What did your surgeon say about these spasms?

What is your activity level each day? Are you doing a lot of exercises and rehab? Sometimes overdoing such things can bring on spasms like this.

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.

Just keep in mind all people are 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.

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.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[Layla]

Hello and Welcome to BoneSmart. Thanks for joining us!
I am sorry you have to deal with the uncomfortable spasms you described. I am wondering why your surgeon changed your pain medication and if you had the same reaction from whatever you were taking previously? Some people do deal with spasms post op, but yours sound rather lengthy and intense. Have you tried massage?
You may want to speak to your surgeon about the possibility of a muscle relaxer, or you could try something like Magnesium which may help also.

Magnesium supports the following:
Bone health
Healthy blood sugar
Cardiovascular health
Muscle relaxation and nerves
Promotes healthy sleep (falling asleep and staying asleep)

An article on Magnesium -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

Since the spasms sound more severe overnight you could also try drinking 4-6 oz of Q-Tonic before bed which is a water that contains quinine. Read the label as some of the waters do not contain quinine, but quinine flavoring instead. Give it a try and see if it helps. Also, make sure you're staying adequately hydrated.

I wish you comfort and speedy relief. Please stay in touch and let us know how you're doing.
@backwater

 

[backwater]

What did your surgeon say about these spasms?

He seems to think it will pass but if still a problem at next visit and x ray will look into it.

What is your activity level each day? Are you doing a lot of exercises and rehab? Sometimes overdoing such things can bring on spasms like this.

I do my therapy exercises but don't push it. Therapy down to 2 days a week. exercise bike on level 2 for 5 minutes then heel slides, stretching on ramp, leg lifts standing and lying down, raise up on toes. all at ten reps twice. about 8 different exercises. been using my cane the last week. I do short walks, 200 feet would be max.

I am wondering why your surgeon changed your pain medication and if you had the same reaction from whatever you were taking previously?

Was taking hydrocodone and tramadol and pain was bad so switched to oxycodone and it's helping unless i forget and take late. days of therapy i need to make sure i take it as it worse. i take one every six hours but take two in evening and next dose about 3 AM. I take cyclobenzaprine at evening dose too. will try magnesium and elevating higher. Thanks for the help and will read though the links.

 

[Jockette]

all at ten reps twice. about 8 different exercises.

160 total reps is a lot at one month post op. You are not training for an athletic event, you are healing from a lot of surgical damage from major surgery. Cut way back on those exercises and your pain will likely reduce. Remember, rest is an important component in this rehab. Don’t look at it as doing nothing, look at it as giving your knee the best opportunity in which to heal.

Regaining our ROM does not require forceful bending or painful exercises.
Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[Layla]

You may want to take a step back from all of the PT activity. The sessions and the exercises. What you're currently doing is a lot and you mentioned you are down to two days a week, so it's safe to assume you were doing more up until recently. Ten reps of eight different exercises is a lot for only one month post op. Walking 200 ft is the equivalent of approx 70 big steps. I am not certain how many times a day you're doing this, but if its only once, or even a few times daily, consider increasing the walks as your exercise, coupled with the activities of daily living. I'd encourage you to try this for a couple weeks and see if you notice a decrease in the spasms.
A great rest of the week to you!
@backwater

 

[Ayse]

I'm from Iowa and first joint replacement on left knee. I'm having severe knee spasms that last 10 seconds or so and this happens quite often when laying down. It's in the knee and feels like it's contracting and shakes like crazy and painful. The dr changed pain meds to oxycodone. This helps if i take 2 before bed mostly but still happens maybe depending on my activity that day. It sets me back because the knee is very sore and stiff. I had meniscus surgery twice before and had twitching a few weeks after in the same area afterwards the last time. But that was like a short twitching with no pain. Now it's a very painful violent shaking and twice a kicking reflex. Only relief is sitting up and waiting for meds to catch up or taking another and waiting for that to kick in. Anyone know what's going on? thanks

My knee does this. It did it after my accident and after the 3 surgeries since. It was only at night in bed and shook/jerked like mad for a few seconds each time. It stopped each time when my leg strengthened again. I'm having the same at the moment since my TKR. Fingers crossed yours eases up.

 

[backwater]

Thanks Ayse, and hope yours goes away too. if i get an diagnosis will post it here. My sister in law is having TKR soon and i will send aher a link to this forum. Lots of good info.

 

[sistersinhim]

Oh my goodness, @backwater, you are keeping your baby knee inflamed with all those exercises. You don't knee to do even half of all those. Your knee isn't out of shape, it needs to heal from a very traumatic surgery. You're not in training mode, it is healing that should be your number one concern.

If you read through a lot of threads you will see that less exercise=more healing. As you heal you will be able to do more and your ROM will come in naturally as the swelling decreases. Many of us never took PT after this surgery and recovered just fine and with less pain and swelling. Give fewer exercises for a few weeks to a month a try. You'll probably see much improvement in your pain level, sleeping, and ROM. Your knee knows how to rehab itself all by itself!

 

[backwater]

So after looking around here I'm less worried about ROM at this stage and have a Q or two. What's a good way to get magnesium, are tablets fine? Going to PT in morning and am bringing up the spasms, pain/stiffness and swelling i get after PT and try not to focus on ROM. And how much and often should i be walking, did ten minutes today slow and with cane. Taking Oxy, every six hours, 1 pill 3 times and at night around 8pm i take two to keep the spasms away. The spasms were really setting me back and DR changed from hydro to oxy and cyclobenzaprine which i take once in evening. Thanks for any replies.

 

[Layla]

Happy One Month Anniversary!

Good news that you're less worried!
I would recommend purchasing Magnesium from a place that sources high quality supplements. Try Whole Foods or any natural foods grocer, if you're at a loss for a place to purchase. Personal preference for me is Magnesium Glycinate. Many find it easiest to absorb in this form. It is more gentle on the stomach than other forms and less likely to cause loose stools.

Walking - If you did ten minutes today and felt alright afterward, try going just a bit further tomorrow and see how it goes, increasing time / distance in small increments.

Good Luck at PT tomorrow and remember you're the boss. No pushing you, no pain.
@backwater

 

[backwater]

Thank again Layla. This one step forward and two steps back is not a good plan.

 

[backwater]

Well PT went better and less intense

You may want to take a step back from all of the PT activity. The sessions and the exercises. What you're currently doing is a lot and you mentioned you are down to two days a week, so it's safe to assume you were doing more up until recently. Ten reps of eight different exercises is a lot for only one month post op. Walking 200 ft is the equivalent of approx 70 big steps. I am not certain how many times a day you're doing this, but if its only once, or even a few times daily, consider increasing the walks as your exercise, coupled with the activities of daily living.

Recumbent Stepper is machine they have and i do 5 minutes then i did some calf and ankle streches at my own pace. then She did the scraping thing for first time then a wild tape job to help with swelling. Still had pain an hour after i got home but took a nap ( a couple spasms but way less and not as painful) . I'll walk tommorow morning, rest of today make supper and piddle around as needed

 

[FCBayern]

Taking the PT slow and easy while listening to your body will help you achieve your desired ROM while not causing as much pain and swelling. When you over use the joint (and IT gets to decide what's too much and what's not) it swells and your ROM decreases.
Prior to my TKR I was aware of the BoneSmart gentle approach to recovery as opposed to rigorous PT. I was lucky enough to find the site before my TKR. Even though I knew about the BoneSmart approach my OS was all about PT and "whatever ROM you have when your scar turns silver is all the ROM you will ever have." He was the trained surgeon that has done many, many replacements, he must know what he's talking about right? So off I went to my first visit to PT, about 2 weeks out from TKR. The next day when my knee was more swollen and I was in much more pain I opted for a BoneSmart recovery. I never went to another PT session. That was one of the best decisions of my life. Not only did I suffer less pain, but my ROM has continued to improve over two years. It took me a full year to reach 120 degrees of flexion, and I was still 4 degrees from straight. By the end of the second year I was over 140 and past straight. I've been hiking over rough terrain for miles, scuba diving, and just living a happy active pain free life with more ROM than I ever thought I would have again after many painful years. I've now had a hip replacement with equal success following a BoneSmart approach. You don't have to suffer needlessly to have an amazing recovery.

 

[WillB]

I'm from Iowa and first joint replacement on left knee. I'm having severe knee spasms that last 10 seconds or so and this happens quite often when laying down. It's in the knee and feels like it's contracting and shakes like crazy and painful. The dr changed pain meds to oxycodone. This helps if i take 2 before bed mostly but still happens maybe depending on my activity that day. It sets me back because the knee is very sore and stiff. I had meniscus surgery twice before and had twitching a few weeks after in the same area afterwards the last time. But that was like a short twitching with no pain. Now it's a very painful violent shaking and twice a kicking reflex. Only relief is sitting up and waiting for meds to catch up or taking another and waiting for that to kick in. Anyone know what's going on? thanks

You may be suffering with what I’ve had for several weeks. It may be a restless leg syndrome resulting in a huge spasm which hirts bjt at the same time feels good. Doctor recommended Flexeril which is a muscle relaxer. Seems to be making a difference.

 

[backwater]

You may be suffering with what I’ve had for several weeks. It may be a restless leg syndrome resulting in a huge spasm which hirts bjt at the same time feels good. Doctor recommended Flexeril which is a muscle relaxer. Seems to be making a difference.

I take a cyclobenzaprine about 8pm. Well spasms have pulled a fast one and started again last night so no sleep till 3 or 4 am. Then i got up about seven and ate a little then back to bed but super painful spasms kicked in hard off and on till 11am. My knee and thigh swelled worse and just had a lousy day. A friend was needing some Alka-Seltzer cold and flu so i went to store for him and got a few things i needed. Kinda helped me keep my mind off things. Back of my lower thigh into knee is always swelled up and the ligaments and tendons are bow string tight and painful. Been icing and wondering if this last spasm fest was brought on by icing to long. Started taking Tylenol about noon and going to keep that up along with the oxy.

 

[WillB]

You may be suffering with what I’ve had for several weeks. It may be a restless leg syndrome resulting in a huge spasm which hirts bjt at the same time feels good. Doctor recommended Flexeril which is a muscle relaxer. Seems to be making a difference.

I take a cyclobenzaprine about 8pm. Well spasms have pulled a fast one and started again last night so no sleep till 3 or 4 am. Then i got up about seven and ate a little then back to bed but super painful spasms kicked in hard off and on till 11am. My knee and thigh swelled worse and just had a lousy day. A friend was needing some Alka-Seltzer cold and flu so i went to store for him and got a few things i needed. Kinda helped me keep my mind off things. Back of my lower thigh into knee is always swelled up and the ligaments and tendons are bow string tight and painful. Been icing and wondering if this last spasm fest was brought on by icing to long. Started taking Tylenol about noon and going to keep that up along with the oxy.

Your actually taking Flexeril. I’m at 10 weeks post op and sleep is and has been the greatest challenge. Walked quite a bit today and my knee reacts. Longing for the day the pain and ache will be gone! Now when the H that will be!

 

[backwater]

WillB is the flexeril helping you? Willing to try anything SLEEP, i can feel tired then lay down but wide awake again. Or the spasms wake me up and pain spikes up so no sleep. Hope your getting better

 

[backwater]

I get it now WillB , Flexeril is cyclobenzaprine

 

[WillB]

WillB is the flexeril helping you? Willing to try anything SLEEP, i can feel tired then lay down but wide awake again. Or the spasms wake me up and pain spikes up so no sleep. Hope your getting better

Flexeril does help with the restlessness and leg spasms. Not hugely but it is helpful. Zingers and sharp pains have either disappeared completely or significantly reduced, but the dull ache is pretty persistent.

I get it now WillB , Flexeril is cyclobenzaprine

you are correct- one and the same. Its been helping some. Have discontinued Gabapentin as I don’t think it helped a bit!