PKR Reducing pain meds after PKR

doxie girl

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Good afternoon I am a new member with a few questions about pain. On August 18th 2020 had partial knee replacement. Started on oxycotin but i didn't repond in a positive way so was switched to norco before going home. Tomorrow will be 5 weeks post op.

On october 20th will have my other knee done - possibly a partial too. I continue to take one norco every 5-8 hours for pain. I use ice and change bags about every 2 hours. I have been in physical therapy twice a week since two days after surgery and now in my second week of only going once a week. I have about 3 sessions left before my next surgery.

If i don't take a pain med I become very uncomfortable and have found that tylenol does not really help that much. I have a sensitive stomach with past issues of problems when taking naproxen so try to stay away from it.

Is it normal to still have this pain at week 5? Should I be cutting down or try to stop taking the norco? I would like to have at least 1-2weeks off narcotics before my next surgery? How does one switch from narcotics to non narcotic pain meds?
 
I had a rtkr on August 18th 2020. I have naturally cut down on my norco but still have to take more on some days. I wouldn’t worry about getting off the pain killers. I don’t know if there is less pain with pkr but your body will let you know when to stop. Good luck!
 
It is very normal to have a fair amount of pain after any replacement, at 5 weeks post op. Almost the same work is done with a partial as they do with a total, just not quite as much. Bones are still cut and implants put into the bone, and lots of soft tissue disrupted. Recovery from either a partial or a total takes an average of a full year.

This really is true, I also have a partial and did not get the “ quicker” recovery I repeatedly read about.

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.
 
Please specify which knee goes with which date, and we’ll make a signature for you.

While pain in recovery is to be expected there are some things that can affect it. Too much activity, including some of the exercises we are told to do, can increase our pain. If any activity specifically increases your pain, then your knee is not ready for that, so try not to do it until you heal more.

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.
 
I'm at about your stage in recovery. I stopped narco cold turkey at about 3 wks. Just could not deal with side affects, constipation, nausea etc. I went from narcotics to tylenol and advil around the clock. I still have pretty bad pain especially when inactive during sleep. It takes ice and elevation to get it tolerable. With my first TKR I had pain for months and it still gets stiff and slightly at times. This surgery is not for sissies but hopefully will be worth it.
 
Hi doxie girl! You've gathered some great advice but wanted to add my two cents. We all heal at our own individual pace. I took my pain meds for longer than 5 weeks, but was tapered down to a lesser one as that time passed.

I'm guessing you have a wonderful, or maybe more, dachshund? I've had two in my life, such loving, protective pups!
 
I had bilateral TKR on July 6th. I never felt like I had enough pain medication. I had to start rationing it at the 2 week mark. My doctor did give me additional prescriptions (Hydrocodone and Tramadol) but not enough to take it on a regular schedule. He cut off pain meds at 6 weeks. Through rationing, I had enough to last through 7 weeks with about 5 Tramadol left to take when I had a really bad day. Other than that, I used diclofenac gel, a heating pad, ice packs and regular doses of Advil and Tylenol. I’ll be 12 weeks out on Monday, and there are days I wish I still had a couple of Tramadol left. In the USA, doctors do not give their patients enough pain meds.
 
Thanks Doxie Girl for asking as I have had the same question.

I am at five weeks fromTKR taking 10 - 15 mg of oxycodone a day along with Tylenol. I definitely see a correlation between activity and pain level. Most days I do close to an hour of ROM and strengthening exercises (including some for my back too). If I don't do much else and do elevate and ice, 10 is OK although I don't sleep well. If I am on my feet much in addition such as shopping, then I need more. Thanks to this forum, I have stopped worrying about it.
 
@doxie girl
I had a bilateral TKR in May 2020. At week 5 I was still using Endone. I only used them at night as they made me feel sick and I hated the constipation issues that came with them. When I had the last of my follow up visits at 11 weeks post op, my surgeon told me he saw no problem with me taking Endone or Tramadol at night ( this is when I was having the most pain). He gave me a prescription for Tramadol as I didn’t like the Endone.I continued to use them as required.

I am now 4 1/2 months. Not having used the medication all the time I still have some left. If I have had a busy or particularly bad day I will still occasionally take a Tramadol.

At 5 weeks I can understand you still needing strong painkillers. If you would like to be off them before the next surgery could you begin to reduce the number of doses in a day ?
 

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