TKR Post-op Spasms

BionicMama

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Good hello everyone. I had a right total knee replacement on June 2nd and have found this board very helpful in answering questions that came up over the past week and a bit.

Today I wanted to ask if anyone else developed severe muscle spasms to their surgical leg a few days after having their knee replaced? Prior to surgery I would sometimes having spasms in my right hip if I was over extending it but never in my knee. These spasms seem to worsen when I’ve exerted myself, like after physio or showering. It feels like my entire knee twists up suddenly and then let’s go after a few seconds. At times when I was asleep I’d awaken to a spasm that made me scream and start crying which has terrified my whole family.

Is this normal!? I’ve done some reading that mentions they could be a side effect from the nerves being disrupted but does it go away?

Thanks in Advance!
 
Hello and Welcome to BoneSmart and recovery! Congrats on your new knee!
Please rest assured, you are not alone in experiencing spasms post op. These unexpected spasms usually appear as you're healing from surgery. The spasms will go away. If they are really bothersome, you can call your OS and they may prescribe a muscle relaxer short term.
Also, you may want to consider Magnesium.
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/

For the overnight - This may be worth considering....I've read of 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.

I will leave our Recovery Guidelines below with best wishes for a smooth recovery. Thanks for joining us. Please stop back often to share your healing journey with us. I hope the spasms abate soon. :)
 
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
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

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.
 
Hello @BionicMama and welcome! :welome:

I'm glad you found BoneSmart and that the forum has been helpful to you so far. Please let us know if you have other questions or concerns. We're here to help!

Wishing you speedy healing.
 
It sounds like you might be describing RLS, (restless leg syndrome). I also experienced them and they bout drove me crazy. Between those and zingers, sleep was fleeting for about a month. The good news is that they go away with time!
 
@BionicMama You described my night last night! Damn those spasms. Mine happen almost every night and I finally figured out my knee really wanted some stretching. I did a couple minutes of gentle heel slides then walked around a bit and they went away. Tonight I'm going to be proactive and do that before I go to bed.
 
It’s been a rough few days. My muscles contract into a hard ball every time I try to do my exercises and at times the pain has been blinding. I’m trying to not use my narcotics because when my husband went to pick up my prescription last week, the pharmacist told him he was worried I was abusing the medication. I’d been given 45 tabs of Oxycodone with instructions to take 1-2 pills every 4 hours as needed. I only ever took one except on one particularly bad night, and averaged at 4/day. It was day 12 when this happened and I had to argue with the pharmacist to release the script, even pointing out that the math doesn’t make sense - if I filled it and took one tab every four hours, I would have run out MUCH sooner. It was humiliating and has now made me paranoid to take them at all.

Somedays I feel like I’m making progress, others I fee completely defeated. My family tries to be supportive but I can see the annoyance and frustration in their expressions and tone with me. So I try not to ask for anything and push through trying to finish things I myself. The biggest piece is not being able to drive yet. I’m 100% dependent on my husband to take me to physio appointments and anywhere else I need to go. We are not close enough for me to take a car service, otherwise I’d just do that to avoid the sighing and non stop chatter.

Tell me this gets better?
 
Tell me this gets better?
Yes it does get better. But it is still very early days for you.

If you are not taking your prescribed medication then you need to find an alternate pain med. You need medication to regain mobility. Have you tried paracetamol? Can you take ibuprofen? Alternating between these 2 OTC drugs can be very effective.

Are you icing your knee? I suggest you stop trying to exercise and let everything settle. Just do gentle stretches throughout the day.
 
Tell me this gets better?
Yes it does- but you are really really early.
I am at 7 months and can now do pretty much everything I need to with little or no pain ( walk 10- 15000 steps/ day, go up and down many flights of stairs normally, stand for long enough to cook meals etc, drive, travel by train by myself). But it has been a slow recovery and it is only in the last couple of months that some of those goals have been achieved.
You really need to rest/ ice and get your family to understand that you will need help for quite some time.
I found there was a stage at maybe 3-4 months?? when I felt embarrassed still asking my husband to fetch things from upstairs- but if I did too many stairs I still really suffered and my knee flared up again and got sore.
 
when my husband went to pick up my prescription last week, the pharmacist told him he was worried I was abusing the medication.
If your pharmacist actually said this, it is none of his business. This is between you and your doctor! I bet he never had a TKR!
 
@BionicMama I am now just over 3 weeks since my knee replacement and yes I am suffering like mad with restless leg syndrome, in fact it comes and goes, one day I could be fine and then another it’s awful, I had a terrible nights sleep last night as it was driving me mad and I kept waking up and massaging my calf. I am going to go and buy some magnesium supplements as I know that these help with this feeling, just hope it goes away soon.
 
If your pharmacist actually said this, it is none of his business. This is between you and your doctor!
Unfortunately, everyone in the chain, doctor, pharmacist, drug manufacturer and distributors, can be held liable for abuse of opioids. The pharmacies are expected to have systems and controls in place to detect abuse and take action. If they fail to do so, they can face criminal and civil penalties. They are not doing this to be mean, but to protect themselves. It’s just that patients that are not abusing their meds but really need them are getting caught up in the rules and guidelines that are set up to prevent abuse.
 
systems and controls in place to detect abuse and take action. If they fail to do so, they can face criminal and civil penalties. T
Surely if they think this they should be contacting the prescriber and/ or reporting them to the authorities- not taking it out on the patient?
 
Unfortunately, everyone in the chain, doctor, pharmacist, drug manufacturer and distributors, can be held liable for abuse of opioids.
This might be true, but for a TKR patient not even 3 weeks out of surgery, this comment was insensitive.
 
this comment was insensitive.
I did NOT make an insensitive comment. I also said:
It’s just that patients that are not abusing their meds but really need them are getting caught up in the rules and guidelines that are set up to prevent abuse.

So you can see, if you read the entire message, that what I said was that innocent patients are caught up in rules created to detect and prevent abuse in others.

You can say all you want that it is not the pharmacy’s business but as one example, CVS and Walgreens had to pay huge fines (>10B USD total) as part of a settlement for the part in the opioid scandal. These kinds of incentives do change behavior, for better or worse, and sometimes both. CVS now has strict rules and I have had my own prescriptions modified by them (smaller quantities than prescribed) on several occasions.
 
I did NOT make an insensitive comment. I also said:
Not your comment, the druggist's comment. Three weeks out of a major surgery and needing pain meds is not a sign of drug abuse IMO. I'm sorry you misunderstood me.
 
I should have been more clear in my reply to you. I apologize, too!
 
when my husband went to pick up my prescription last week, the pharmacist told him he was worried I was abusing the medication.
If your pharmacist actually said this, it is none of his business. This is between you and your doctor! I bet he never had a TKR!
Yes, that was highly inappropriate and annoying to hear a pharmacist ad lib like that.
 

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