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TKR pain

I had TKR on my right knee six weeks ago on 4/8/2015.  I had great gains with physical therapy the first three weeks post surgery and reached 130 flexion.  Then I began to have sharp shooting pains in the back of my knee whenever I would stand up or pivot the knee.  I also started to have multiple muscle spasms, mainly at night, which are unbelievably painful, making getting a good night's sleep impossible.  I have shared this with my orthopedic PA and PTs.  Since then I've been prescribed two different pain pills, two different muscle relaxants, and a sleeping aid.  Nothing has really helped.  X-rays showed that the new knee implant is fine and there doesn't appear to be an infection.  I suggested an MRI but the PA wants to wait.  The PA has told me to wait four more weeks to see if the pain goes away yet the pain is so intense that it makes my daily life difficult.  Has anyone experienced the same symptoms and, if so, what did you do to relieve the pain?

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547368 tn?1440545385
Hello and Welcome to the Pain Management Community. I'm sorry to hear about the pain and issues you are having with your TKR. The members of this forum certainly understands pain that disrupts ones daily functioning.

I am not an expert and obviously you should continue to consult your medical providers - that said I'm guessing the pain is probably associated with the muscles, tendons (such as the patellar tendon) and ligaments in the posterior knee compartment.

The physical therapy that you have so diligently followed with may have caused the area stress and swelling. There may even be some fluid build up. When these internal tissues and/or structures swell it can produce some nasty pain. The swelling and use brings on the spams and it feels like a vicious cycle. You are most likely exercising areas that haven't been utilized for awhile, due to the pain and limitations your failing knee joint imposed upon you.

Your medical providers may be thinking that with continued PT and time the trauma and swelling will reduce thus eliminating any major pain. If this doesn't happen or if the pain intensifies I encourage you to repeat your request for the MRI.

Before you take any suggestions that I or others might offer please check with your providers. Often alternating cold and heat can ease the pain. Heat may increase the swelling so check with your PT. Ask if a burst of steroids may help. This can often reduce swelling however it may be too soon for steroids. Be sure to take all the meds that have been ordered for you. Sleep and comfort are important. If the meds are not effective be sure to discuss this will your physician.

What I do know for certain is that you must keep moving that knee. If the pain is extreme or it frightens you and you don't exercise - the joint/knee can freeze up. A close relative failed to follow PT orders after a bilateral TKR, now her knees no longer bend or function properly.

Be assertive and ask lots of questions. This is your body. I hope you will let us know how you are recovering. I'll watch for your updates. If you have additional questions or I wasn't clear please feel free to ask.

Take Care,

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st. louis, MO
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