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TKR Night pain

MistyBlue155

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I’m new to bonesmart. I was googling in early hours regarding getting sleep, and this site came up on a u-tube video. My TKR was March 26,2021. The pain at night keeps me up all night every night. I take pain pills, ice, elevate, up and down all night. I do PT 3 times a week, maybe this is to much? Any feedback or ideas that work for you would be greatly appreciated.
 

Jaycey

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@MistyBlue155 Welcome to BoneSmart! Which knee did you have replaced. We will put the information in your signature for you.
I do PT 3 times a week, maybe this is to much?
Is your PT excessive? Are they pushing that knee bend? Three times a week does seem excessive. And if there are pushing it's too much.

I would focus on icing and elevation. Get all that swelling under control. That is what causing you pain.

Here are our recovery guidelines. It's not too late for you to get back on track with this recovery:
Knee Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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 Activity progression for TKRs

6. Access 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 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.
 
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MistyBlue155

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tkr on left knee. 123 degree bend. I will talk to them Monday and change to 2 days. Thank you
 

Celle

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Pain at night is usually caused by two things:
  1. Under medication
  2. Over-activity during the daytime.
At less than a month post-op, a bend of 123 degrees is more than expected.

I agree with Jaycey - there's no need at all to keep going to PT 3 times a week.
Your new knee needs time to rest and recover from major surgery, but all this PT is keeping your new knee irritated and inflamed

Once a week is plenty for PT. You can do a few exercises on your own for the rest of the week.
This is a year-long recovery, so you have plenty of time.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Make sure you're taking your pain medications on a regular schedule, and give your knee as much rest, ice and elevation as you can, to help it to calm down and reduce its swelling.

Just in case you think you can't control how much PT you do, read this article:
Saying no to therapy - am I allowed to?
 

Sisterpat

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Welcome to the site, Misty! Check in daily and read everyone’s experiences - it is very helpful since you realize you’re not alone on this journey. The moderators have much experience and great advice, too.
 

sistersinhim

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Wow with that bend! You certainly don't need to be working on that. PT should mainly be working on your gait and you can do that at home, if you want to.

Nighttime pain is usually an indication that you are doing too much during the day. Try backing off for a couple of weeks and see if that pain gets better after that. Your knee is in the angry tissue stage and any little extra thing will set it off. Getting movements is all it needs to heal properly.
 

FCBayern

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Many of us here never did formal PT @MistyBlue155, myself included. 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. I've been hiking over rough terrain for good distances, 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.
 

sistersinhim

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I was blessed to have a surgeon that never pushed PT. He gave me a prescription for it, which I threw away and never went. When I went for my 3 return checkups, all he wanted was to see what my knee would do. Never one question about PT! Of course, he knew I was a single lady that had to take care of myself, so obviously he trusted that I would not be just laying around all the time.

After 12 knee surgeries, I know that I do not need PT, and neither does anyone else if they do their own daily activities. My knee recovered just fine all on its own with only my daily activities. I didn't have the terrible swelling or agonizing pain that so many have after taking formal PT either. I knew the Bonesmart way worked before Bonesmart was even thought of. My surgeries started in the early 80s and I never went to PT even back then. I just didn't see the need for it. Bonesmart was formed around 2004. By then I had already had 6 knee surgeries and rehabbed the Bonesmart way!
 
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MistyBlue155

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With this being my first surgery, I am learning a lot on Bone Smart. I will be taking a different approach in reference to PT. Thank you
 

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