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Pain Management Community
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Avatar universal

I had Total Knee Replacement 5 weeks ago and I am still suffering severe pain especially at night.

My surgeon is managing my pain I have been on numerous pain medicinces including Fentynal patch, Diludid, Percocet, Norco, and now Oxycotin. I am in my 5th week of recovery and most of my pain is at night when I go to bed. It is a severe aching and throbing that starts at the knee and proceeds all the way down to my lower calf and shin. I am currently taking 3 10 mg tablets of Oxycotin but still experiencing pain.I also ice my knee down in the evening. I took 4 weeks of physical therapy and my doctor is now having me do 4 more weeks and has me using my walker again. I am 42 yrs. old and doing normal activities, short walks, physical therapy exercises I am instructed to do at home and using the stairs. I rest when I feel like I have done to much. No matter how much or how little I do each day by evening I am in such severe pain it hinders my sleep all through the night. My doctor has mentioned a possible infection but I don't see any redness and my swelling appears normal. My question is this type of pain normal? Shouldn't I be receiving some relief from the pain medication? I am following all of my doctor's directions and my therapists. Is this normal at 5 weeks post op? When should I start expecting some relief?
46 Responses
82861 tn?1333457511
My experience with numerous sugeries is that ortho-related surgery hurts the most and takes the longest to resolve.  I am actually impressed with the amount of opiod meds your docs have you taking.  All I ever got was 5 mg vicodin for my neck and shoulder surgeries.  LOL!  So much of pain management is mental.  There is no magic pill out there that will get rid of all your pain.  Surgery hurts, and ortho rehab work hurts even more.  Try to lay off of the exercises for a few days and see what happens.  It sounds like you're doing a fantastic job in that area, but it may be just a bit too much too soon.  Frankly, I think you need to take a short break.
Avatar universal
You may contact me at ***@**** if you like. I've gone through this surgery and a year ago had a revision to the first...they incised the same scar, and I had to go through five weeks of therapy afterwards.

Pain at night is normal to a degree because your leg is in one position as you sleep until you roll over. I sleep with a pillow under my knee and leg or between my legs so that my knee is supported. After my first surgery, I went out and bought a body pillow because as the knee heals it needs to be straightened, keeping it bent for too long of a period can cause a contracture of the knee. I worked my fanny off in therapy and need to get back at it. You really need to take it easy though and not overdo because you're going through pain now because of your activity.

One other thing that my surgeon told me is that when you're laying down that the blood tends to pool around the area of the surgery and it's something that will subside but can cause extreme pain when it does this. It's just in the early stages of healing and you have a long road ahead but don't get impatient with the healing process...it all takes TIME...

Good Luck and write to me if you like...
NaniKai
Avatar universal
Hi.  I am facing a revision of my first knee replacement in approx 3 weeks also.  I am so scared. I got an infection the first time---MRSA +  and I am facing some horrible risks again.  I would love to talk to you.  I need to talk to someone who has been thru similar surgeries (experiences).  How can we chat?  I have never been to this site until today!  
Thanks.
Avatar universal
I had 2 hips replaced at the early age of 30. I used to bike ride 20 miles a
day for fun,until the surgeries. It does take a person at least a few months
to 6 months after a knee,hip operation,to have the pain be somewhat manageable.
The problems I am currently facing after 3 and 4 years after surgery,is that the
pains in my hips and legs never went away completely. The bone-on-bone pain
that was unreal,is gone,but I have been going through other severe pains on and
off for all these years. My PM Dr. had me on high doses of narcotics all along
which was the worst thing he could have done,since the meds don't work anymore,
no matter how much I abuse them.I'm left an "addict" even though my new Dr. says
I'm just "dependant" on them. I think we,as the patient,can tell the difference.
I,(we) need to try and get down to what is causing our pain,instead of masking the
pain with drugs. When you are in real pain in the future,no amount of drugs will begin
to give you any type of releif. It's not meant to scare anyone,just the God's Honest Truth.
God Bless All.
Avatar universal
I am 10 weeks post op TKR and 5 weeks post MUA, and having severe pain medially, and very poor extension. I am scared. My knee sticks out pretty far, and I have alot of trouble walking....anybody had this problem?
1 Comments
Yes, I think this is a lot more normal than is let on. Made worse by lucky ones that crap on about how we should toughen up!
Avatar universal
I had a Total Knee Replacement 6 months ago because of Arthritis (I am 57) and had the usual problems at the start, infection, pain, pins and needles, electric shock feelings etc Then on the 4th month after surgery could do without crutches or sticks as I worked very very hard at the Physio exercises to mobilise the knee. It bends past 90 degrees and completely straightens.
Then a few weeks ago, I got up one morning and couldn't put my weight on it for the pain under my knee and all down my shin. It has been like that ever since. I am now back to 2 crutches and severe pain. Surgeon thinks maybe infection but Antibiotics have not cleared it!
Anyone else had this problem.........and if so....what was the outcome please.        Ann
Avatar universal
I just started visitng this site a few days ago.  I am sorry you had such pain but I am encouraged by all I am reading about others with Total knee replacment pain following surgery.  I was beginning to think I was crazy even though my surgeon has never made me feel that way.  I had my TKR on 5/17/07 and I have struggled with horrible, unrelenting pain since then.  I have done 51 sessions of intense physical therapy, I have had a manipulation under anesthesia,  and arthroscopic surgery to remove massive scar tissue and after each of the last two procedures the first week seemed better but now I am back to all the pain, swelling, cold extremity, hot incision site etc.  I too am being followed by a pain management Dr.  I am taking 20 mg of Oxycodone Extened Release twice a day and using 5 mg Ocycodone Immediate Release every 6 hours for break through pain relief.  I have build up a tolerence and the meds don't really help.  My Dr. is going to move me onto something stronger.  You said your Dr. mentioned possible infection and you don't see any redness.  My surgeon has been and still is suspicious of infection in my knee.  He has done numerous CBC's, C reactive test, ESR, ultrasounds, indium labled bone scan, a nuclear bone scan, and has aspirated the knee and sent the fluids to be tested (when he did the manipulation).  All of these tests were negative for infection.  That still does not mean there is no infection.  Pain is the number one symptom for infection.  My surgeon told me about a lady that had horrid pain and at about 14 months post op they found infection.  In fection in a total knee can be hard to diagnosis.  I hope this
information is not needed and you are all healed up.  Would love to know how you are doing. Age 42 is so young for a TKR, do you mind sharing the reason for the TKR.  My was for severe Degenerative Joint Disease.  The surgeon first attemted to clean up my knee arthroscopically but when he got in there it was worse than the MRI's showed.  My other knee needs something done but I am scared to death to go through this again.  
Shelly3582
547128 tn?1214542703
I am almost 69 yrs. old.  I had a total knee replacement done June 11th and sent home June 15th with my operated site full of very huge purple/redish blisters.  Sent home with a prescription of antibiotics.  Next day or so noticed red wide line about 2 inches wide travelling down from operated knee to my ankle.  It was very hot.  I finally showed the nurse assigned to come in to my place and she was very concerned and when the Physio gal came tohave me do exercises she looked at it and was agast at what she saw.  She phoned my family Doctor who told her to have me go to the city about 40 miles away where the surgery was performed.  I went that afternoon to emerg and a Doctor looked at it and decided to put an antibiotic in my vein as well as a prescription to take by mouth along with the one I was taking from the day I was sent home.  Two days later the knee where the blisters were became all red and hot to touch also.  All the time I am enduring such throbbing pain and sharp pain below the knee around the shin inside where the redness was.  Two days later I spoke with a friend who is a nurse at the same hospital and she put a phone call into the surgeon who phoned her back at her home and told her to have me go to his clinic at the same hospital at 7:30 a.m. within the next few days.  Meanwhile I once again packed my bag and went to the emergency a day before I was to be at the clinic.  A special nurse tended to me and she had another antibiotic put into my vein and sent me back home to my home town only to have me go back for the 7:30 a.m. clinic appt.
As soon as the surgeon saw my knee and my leg he ordered me to have 24hr antibiotic pumb.  I had a tube about 49cm put in my upper arm to go into the vien near my heart and that night the nurse came to my apt. to hook me up.  That was just this Tuesday past and yesterday (Wed) the nurse came in again and hooked up another bag as well as Thursday and will keep doing this until the cellulitis clears up.  Today when I saw the Dr. in his office he told me I would have this pump hook up atleast another two weeks and he wants to see me again this coming Monday at Emergency in my home town since he is there for the day so that I do not have to have someone drive me back into his office.  Can anyone give me some encouragement who has beeen through this.  I was in a room with a patient found to have the mrsa virus and as soon as they discovered it they moved me into another room but could the two days of sharing a room with her have something to do with the infection.  This has surely set me back with my physio as I am to keep my leg up and yet do exercises on a board in my bed???.  My nurse said today when she came that the wide line down to my ankle is still spreading.
Avatar universal
I had my total knee replacement surgery on Sept. 22, 2008.  It is now October 18, 2008, I am experiencing a difficult time with sleep.  I have been averaging about 2-3 hours of sleep a day, this is driving me crazy.  I finally went to the store and purchased a sleep aid and that seemed to help some, I don't like to take a lot of medication, but this is the only way that I can get aleast 5-6 hrs of sleep.  If you have any idea as to why I can't sleep without taking the sleep aid please let me know what you think.  The pain med that I take is percocet, I take 1-2 tabs a day.

Joyce   e-mail:  jam-***@****
535089 tn?1400677119
This is an old post. Please start a new thread.....Thank's
Avatar universal
Hi there, you are a short timer so be patient.  I had mine done 12 weeks ago and do get pretty impatient at times.  My PT told me that for the first 3-6 months I would experience pretty sleepless nights and that has been true.  It is getting better now though but some days are good and some not so good.  Be sure to elevate the knee above your heart a few times during the day so the blood and lymph can drain away from the knee area.  I just lay on my couch and put my leg up on the back of the couch for a few minutes a couple times a day.  Be sure you are icing, icing and more ice!  Also, do your exercises faithfully.  Hope you feel better soon, but it does take time. I get frustrated because I seem to be limping and not bending the knee like I should, but I just keep at it and hope that will go away soon.
1 Comments
Thanks for the encouragement. It's been a long while now. My knees are doing great! Happy to have had them replaced.
Avatar universal
Oh my, I just noticed that tkp had their surgery a year ago, so I guess I didn't need to post the info for them.  Hopefully it will help someone else out there.
1 Comments
Thank you as it helped me.  I had TKR of my left knee on June 1 2017.  I know it is only early days yet but the pain at night is a killer.  To know that this can last for three to six months at least gives me hope of it ceasing some day.
Avatar universal
Yes, your post did help someone:  me.  I had TKR on June 21, and today am feeling so discouraged because my pain has increased the past 2 days.  Reading your post reminded me to elevate more, and to spend more time with ice (I still use ice, but not nearly as much as at first).  I am so tired of not sleeping at night, and dealing with pain, but yes, I do my exercises faithfully.  I think perhaps I push myself too much. A few days ago, I was so excited that I could bend my knee fully to ride my exercise bike, I rode for 30 minutes, hard and fast!  Also, 2-3 days per week I make myself go on a long walk.  That is in addition to PT 2 times per week, and exercises at home several times per day.  Friends suggest  I am doing too much.  Any feedback from anyone would be appreciated!
Avatar universal
Hi Tricia,

This is a VERY old post and this poster is no longer active on here. If you would be so kind as to go to the top of the page and click the Green "Post a Question" tab and re-post I would LOVE to be able to post and hopefully help you!!

Thank you......Sherry

PS I'll be waiting for your NEW post!!
Avatar universal
I am 5 weeks post op from the TKR surgery. Then last week I have noticed a "funny" feeling on teh outside of my leg. running down to my foot & sometimes up my leg. It feels like a nerve or something. Whe I stretch it I can feel it more. I have done 6 weeks of therapy & was at 95 degrees. I did put my walker aside & used a can a few days &also did more physically. Could I have overdone?? Should I back off?  This is the strangest & most painful, aggravating surgery I have ever had. I feel I ned more pain control but I understand the docs need to wean you off.
There is so much more I need to ask...  Thanks,  Sis
  
Avatar universal
This is my first post to this group.
I am right behind you Tricia, as I had mt TKR on July 2nd, 3 months ago.  I'm currently at 103 degree bend but have been there for about 3 weeks.  Getting a little frustrated with lack of progress but most people tell me that it is still early.  The physical therapists seem to think I am close to a manipulation.  Has anyone out there experienced this first hand, if so, what do you think?  Did it help?  I go to the gym almost everyday and do physical therapy 3 times a week I've always had a very active lifestyle.  I'm 61 years old, my friends also tell me I should slow down.  
Feedback from anyone would also be appreciated.
Avatar universal
I posted an earlier comment earlier in which I said I bought TENS hose.  I meant to say TED hose.  It did reduce the swelling, but that is still my biggest problem.  It's much smaller now, but I still can't get the ROM I need.
Avatar universal
I am working hard also on ROM.  I totally do not want to go the manipulation route because I have to get back to work by 2/4/11. I had my surgery 11/10/10.  I just started using Dynasplints.  One splint is worn two times per day two hours per day for straightening the leg.  I am almost straight already, and the guy who fitted me in two weeks I would be totally flat.  The other splint is worn on the bottom of the leg at night in bed.  It gently continues to bend the knee all night.  He said in two weeks I should be at least at 120.  The only problem with the spint at night that I am having is the pressure on the inside of my lower leg.  I had terrible bruises there after surgery, and it is still tender.  I am hoping to make it through the night tonight.  It is my third try.  The splint that straightens my leg doesn't bother me at all.  I am very hopeful this will work.  I have also increased my therapy at home and at the clinic.  The splints are covered by insurance if the doctor writes a prescription.  Good luck.
1 Comments
How much bend have got
Avatar universal
Any advice on how to reduce swelling?  I have used ice but it didn't work.  TED hose have helped somewhat, but there is still enough swelling it is impeding my progress for ROM
Avatar universal
had my knee replacment five weeks ago i am finding it very stiff when i am walking getting ciosurned
Avatar universal
I'm just past 4 weeks - my surgery was 2/2.  I am doing my exercises but from day to day the stiffness and pain are different.  I am using Norco for pain management.  Night time I lie with my leg elevated (I'm in a hospital bed until I can turn over and manage a regular bed) and do dorsiflexion. (http://en.wikipedia.org/wiki/Dorsiflexion)  The dosiflexion is a gentle movement and I find it helps ease the tightness of the calf muscles.  Last night I had so much tightness and pain - but I did my dorsi exercises and this morning my calf wasn't tight and hurting.  I still have terrible tightness in my knee, at the side and a bit behind.  Some days are easier than others.   No two are the same so on the days when I'm tighter I become frightened something is wrong.

I do a lot of breathing also.  Deep breath in and imagine the exhale is clearing the area that is hurting so much.  I find this helpful when I cannot sleep and the pain meds are not totally managing my pain.  I also try to imagine healing in my knee and find visualization and breathing to be most helpful.

I hope this helps you.  The only thing I hear from people is rest, exercise, eat well and stay ahead of the pain with medication.  I've been told body tissue heals in about 8 weeks - so there's a lot of healing going on -
when I do too much in one day I pay for it the next.  I now build in a nap between 1 and 4 pm and find I am feeling much better.  Sleep is a time the body can heal itself.

Bobbie
Avatar universal
I had a total knee 3/05/2012 been doing PT since. This Thursday 5/31/12 is my last day however I am having pain that started during the week end.  Pain on the top of the knee by the incision and at the bottom of the knee on both sides of the incision.  It is painful to the touch as well as painful when walking.  Not hot thankfuly but just a tad red. I do not know when this will end..  do not know if I should call the doctor or wait it out.. So depressed over this knee business and my right knee is hurting pretty bad at this point.. Not much cartalidge there either. Has anyone experienced this and have any suggestions.. I know it has been said that total knees take a long time to heal. Thank you all for your time an attention.  Donna
29837 tn?1414538248
Had my knee put in about 1.5 years ago. I've had multiple right and left hip replacements and I must say the knee replacement was by far the most painful. The time given to me by the surgeon for recover is one year.

Have you asked your doctor about the circulating ice water system?
http://www.polarsoftice.com/softiceactive.html

That helped me a lot. There are a lot of nerves and muscles surrounding the knee. When they do the surgery, they have to detach some and move others around. Therefor all the pain. The hip cavity on the other hand has much less nerves and muscles to contend with.

Had my knee put in Jan 4. The knee was finally pain free on March 27.
Hope this is a guide to the upcoming events. Take good care of the knee. It's a gift you should never abuse.

Magnum
Avatar universal
I had a total knee replacement 12 years ago. I was swimming at 6 weeks, playing golf at 8 weeks playing tennis at 8 months. I have taken up cycling cause im bored with the other activities. The problem is if i cycle 20 km my knee is fine but if i cycle more then 20km it feels a little stiff the next day. Does anyone else have this problem?
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