Category: Knee Pain

Pain In Knee After Knee Replacement Surgery

Yes, it’s normal to have pain in your knee after having knee replacement surgery. But, the questions that many people have are similar to “How much pain is normal?” and “How long does it last?”

To answer the first question, take a look at this knee replacement video and it sort of gives you a good idea of what takes place and why you have as much pain as you do.

Having your knee joint removed and then replaced with “after market parts” is a major and traumatic procedure!

So, yes it’s normal to have pain. But some say that the pain, although intense, is different than the arthritis pain that they had prior to surgery. Whereas the pain from an arthritic joint is “sharp and intense” (and will just get worse over time), the pain after having a joint replacement is more “tight and throbbing” and usually subsides over time.

“But I have pain in my knee replacement a year after my surgery. Why doesn’t it go away?”

If you’re still having pain months after you’ve had joint replacement surgery there could be a couple (or more) things that may be going on.

If you fit into the above category, then you’ve probably already been to see the surgeon (and any other doctor you can) to have the knee checked out. Many times the doctor will take an xray or a CT scan to see if everything looks good at the joint level. Depending on what your knee replacement is made of your doctor may (emphasis on may) order an MRI.

In many cases the knee components are in alignment and their doctor may say “everything looks good. Give it more time”. This may frustrate people that are in pain because they think the doctor believes their making things up or just complaining.

In all honesty, it’s not that the doctor doesn’t believe you. It’s just that when they look at the x-ray, there is no obvious problem that jumps out at them and there’s no clear indication of what can be done to relieve the pain. They don’t want to open you up and then not find anything to do with you.

What Could Be Causing Pain After Knee Replacement Surgery?

One of the most common problems with pain after knee replacement surgery is plain old muscle pain. You can get muscle pain from having a combination of weak and tight muscles.

In a lot of cases, patients who’ve had knee replacements go thru the initial basic range of motion exercises right after surgery. But, after they have their range of motion back and find that they can get up and move around without much debility, they get on with everyday life and cut the rehab exercising short.

Because of this their quads are generally still relatively weak (along with their hip abductors) and the knee flexor hamstrings and calf muscles are relatively tight.

Having weak quads and tight knee flexors (not to mention a tight ITB – iliotibial band) can lead to over use syndromes and continued knee pain.

It’s important to have your therapist set you up on an independent rehab program for advanced knee replacement exercises. This program should be complete with goals and time frames once you’re discharged from physical therapy services. This is especially true if you’re going back to a relatively sedentary lifestyle at work behind a desk or sitting in a car (or anywhere) for long periods of time.

I’m Pretty Active And I Still Have Pain A Year After Surgery

If you’re one of those that have really been diligent with your exercises and have honestly tried to get back into an active lifestyle but you can’t because of your knee pain, you may need to have your doctor think outside the box about your case.

In some cases, people are allergic to or develop allergies to some of the materials that the knee replacement is made of. Your doctor should be able to test for this. And, you can also do some online research about your particular prosthesis.

The hospital should be able to provide you with a copy of your operative report which indicates what type of “knee” you received. Once you have the name of the model and manufacturer, you can do some research online to see if others have had any similar problems.

Another thing that some people run into is that their knee ligaments may be too tight or too loose and this can cause pain too. If this is the case, it generally requires a knee replacement revision surgery. Yep, it’s another surgery, but, in general, the rehab after a revision is a lot easier than the initial surgery.

Recovery From Knee Replacement Surgery Takes Time

Remember, this is a big surgery that’s mostly done on people that typically aren’t that young. The older you get, the longer it takes you to bounce back.

It’s not uncommon for it to take up to a year for you to fully recover from having a knee replacement. So, just because you’re able to get around without using a walker, it doesn’t necessarily mean that your muscles and tissues don’t need further rehab.

It’s very important for you to keep working on your range of motion. Make sure you’re able to extend you knee to it’s fullest limit. Make sure you’re stretching your hamstrings and calf muscles. Not to mention your quads or the muscles that stretch when you’re bending or flexing your knee.

In addition to stretching make sure that all muscles involved are toned and in good condition. You don’t have to do any aggressive weight lifting. But, remember that a weak muscle that’s chronically overused will be painful also.

Work out a plan with your physical therapist. Do some research about the type of knee prosthesis that was used. Cover all your bases. This way, if you aren’t able to get things working right for yourself, you’ll be honestly able to tell your doctor that you’ve tried everything and that you need them to take a closer look at your problem.

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Pain After Knee Replacement Surgery


Knee Replacement wound which has been stapled ...

Pain After Knee Replacement Surgery (Photo credit: Wikipedia)

” I don’t believe how much this thing hurts”. “It’s crazy”. “If I would have known that it was going to hurt this much, I never would have done it”. These are just some of the comments that I’ve heard from people after they’ve just gone through a total knee replacement.

Pain is something that most of us don’t like and try to avoid (however, there are those special cases that actually like pain, I guess). It’s normal for you to “not like it” since it’s a pretty unnatural and abnormal feeling. But, you know what? In the majority of cases of those who’ve had the procedure done, having pain is something that you’re just not going to be able to avoid.

Pain After Knee Replacement Surgery Is Normal.

If you haven’t done it yet, take a few minutes to watch any video that you can find showing you just what a total knee surgery is. Once you’ve watched one of those, you may start to understand why your knee may be hurting you. Once you get an understanding of how intense and invasive a total knee surgery is, its easier to accept the fact that after a total knee surgery, having pain is as normal as breathing. It’s something you just can’t avoid. But, you can minimize it and get rid of it quickly by following the doctors orders.

Even though you may not be able to avoid it, you shouldn’t have to suffer. There are a couple of tips that people who’ve had total knee surgeries don’t know regarding what could be causing their increased pain. With that in mind, let’s talk about what is actually causing the pain in the first place.

In most cases, after a surgery like a total knee arthroplasty, there are 4 major culprits that seem to cause (or at least contribute to) the pain that you may be experiencing.

Pain from the cutting of the tissues. Remember, having a total knee surgery is like cutting your finger with a knife, but only more so. When you cut yourself, or get cut by someone else, your body goes into “defense mode”. It starts the swelling process, the inflammation process, and generally with cuts or surgical incisions, you have pain from nerve endings that have been injured.

A lot of your pain may be due to this natural response to any bodily trauma. Many people find that when they focus on keeping the swelling and inflammation down with ice and elevation, pain that’s caused by swelling and inflammation goes away pretty quickly.

Muscle guarding. This is a natural response to any injury. It’s a way that you protect the injured leg. But, the problem comes when you’re doing this subconsciously. Keeping your leg muscles tight and rigid will cause a lot of pain.  A lot of people do this when they are just sitting watching TV or laying in bed. Instead of letting the operated leg go limp and thereby letting the muscles rest, the leg muscles are kept in a constant state of contraction and this really increases the pain.

Another way you may be getting more muscle pain is by trying to lift (or lower) your operated leg all by itself and under its own power. You shouldn’t try to lift a leg that’s been recently operated on. The muscles are just too weak for that. Instead, use your hands, the other leg, or, just have someone else help you position your sore leg.

Doing too much. It seems that there are a lot of people who have a misunderstanding about knee replacement recovery. Some people think that “If I can do more, I will get better quicker”. And so they start “trying to get back to normal” too quickly.

There are a bunch of ways that you may be tempted to do this. Some people try to start walking without using their walker. Others try to actually start doing more work around the house. Some people just don’t do the exercises and elevation because they figure “if I lay around all day, I won’t get stronger”. All these attitudes usually end up with people “doing too much” and being in more pain than they really need to be in.

I don’t like taking pills. Here’s another common misunderstanding with people who’ve had knee replacement surgery. There are many people who don’t take their pain pills the way that the doctor has prescribed them. That’s because some think that they’re “going to get hooked” on narcotics. While this is a valid concern, you probably won’t have to worry about it because with resting, ice, and elevation of your sore knee, the pain will subside relatively quickly.

Now you may not have caught on to this yet, but you have direct control over 3 out of 4 of the above causes of pain after knee replacement surgery. This is what I hope you take away from this article. Remember, having pain after any surgery is normal. And, it’s something that you can’t avoid. But, by following the directions of your doctor and physical therapist, you can probably minimize your pain significantly and cut it short in the long run, if you know what I mean.

While there may be no way of avoiding it, you can decrease it significantly and shorten the length of time that you do have pain by using ice, resting it and by not doing too much and being to eager to “get back to normal”.

If you’ve had any experience with knee pain after total knee replacement surgery, please share a little about what helped you in the comments below.


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