pain after knee replacement surgery

Pain I Experienced After Knee Replacement (Day After TKR – 1 Week)

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In this article I’ll share my pain level from the day of surgery until a week afterwards. The hospital always asked me to rate my pain on a scale from 1 to 10. I’ll use that scale and elaborate on specific pain that I felt.

We’ll begin with the pain I felt waking up in the recovery room and conclude with the pain I felt a week after surgery. I’ll share the medications I took to reduce or eliminate pain and how they helped me with my daily activities as well as with my physical therapy.

I will also stress the importance of elevation and icing that reduced both swelling and pain. Unfortunately, pain comes with TKR.

For me it was manageable with medications, elevation, and icing. I’m glad that I followed the directions of the doctor and the hospital to take my medications and not to try and “tough it out”.

Waking Up After Knee Replacement Surgery

When I woke up in the recovery room I actually felt pretty good. I was still heavily sedated and the spinal block was still effective.

As my hour and a half in the recovery room came to an end I was beginning to regain feeling in my lower body. As the recovery room nurse removed my compression stockings he told me that my IV included intravenous pain medication and that once I reached my room my hospital team would develop a plan for future medication.

Once I reached my room the nursing staff attached air cuffs (blue color) to both of my legs to promote circulation.  The air cuffs used air to gently squeeze and release my calf muscles in a similar way as walking (I’d wear these throughout my hospital stay).

They also hooked up a machine to circulate cold water around my knee to reduce pain and swelling. At this time I still had the IV with pain medicine.

I was encouraged to wiggle my toes and move my ankles. At this point I did not feel any pain. After the IV was empty, the nurse asked me what my pain level was.

By this time I was beginning to feel some pain, 5 to 6 on the ten-point scale. She said they would continue to deliver pain medication through the new IV.

I was able to move my surgical knee with the help of the other leg by putting the good leg under the bad and moving it slightly when needed. This was a technique that I had learned years ago when I had broken my leg. I was also able to sit up and adjust positions with the aid of the automatic bed.

After the second IV was finished my nurse explained the pros and cons of the intravenous medication versus the oral medication (pill). She said the IV would work faster but for a shorter duration and the pill would take about 30 minutes to start working but last longer.

At this point we decided that the oral pill Percocet would be right for me. A few hours later when she asked me about my pain level I responded again that it was 5 to 6.

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She said it was best to take the pill in anticipation of the pain, not to wait for the pain to increase and then have to wait another 30 minutes for the pill to kick in.

I began to feel pain above my knee all the way to my groin. I could not figure out why the pain was so severe there so I asked my nurse.

She reminded me that the tourniquet was placed around my upper thigh and there would be swelling and pain for several days. This was my most acute pain 7 to 8.

At 4:00 pm, roughly 6 hours after surgery the Physical Therapist came in for my first session. I had my air and ice cuffs removed and stood up with a walker for the first time.

I could feel pain in the leg especially when I lowered it to the floor and stood up with the walker. It was not severe and I was able to do the simple exercises for the physical therapist. I was also able to walk with my IV’s to the bathroom with a moderate pain level of 5 to 6.

Once the spinal block wore off completely my nurse checked my pain level a minimum of every 4 hours. I began to feel the pain increase as time went by and was encouraged to ask for pain medication when the pain reached 5 or 6.

The 4-hour check became a routine throughout my hospital stay.

Pain After Knee Replacement Surgery – The First Night

After dinner, I prepared for my first night’s sleep knowing I would be woken up every 4 hours for vitals and medication.

It would have been nice if my roommate and I could have had the same nurse because they never arrived at the same time. I woke up every time his nurse appeared too, however I was able to sleep off and on.

The pain was not an issue for me as the pain medication kept the pain quite manageable. The frequent urination, the nurse visits and the traffic in the hall were my biggest interruptions.

I believe the air cuffs that stimulated my legs helped relieve the pain also. The icing seemed to help with the pain, but it was probably more effective with the swelling. I had severe swelling above my knee, around my knee and down to my ankle.

Related: Best Ice Pack After Knee Replacement

I had a fitful night’s sleep but not necessarily due to pain.

Pain After Knee Replacement – The Next Day

walking day after knee replacement - walkerMy nurse managed the pain well that night and the pain level ebbed and flowed during the 4-hour intervals between medications. When I woke up in the morning I felt the same as I had felt during the night.

When the surgeon arrived at 6:00am he removed the drain from my leg. He made a quick jerk which provided a sharp, temporary pain that lasted a few seconds.

I continued to get checked every 4 hours for pain and I was also able to use my call button if the pain was not tolerable. I never used the call button and took medication on a regular basis every 4 hours as directed.

Soon after the surgeons visit I was encouraged to use my walker to go to the bathroom and to sit in a chair for breakfast. I was pleasantly surprised to be walking so quickly after surgery.

Whenever I lowered my leg off the bed, the pain increased a little. The pain was tolerable and I was glad to get up and out of bed.

Moving to and from the bathroom was slow but did not cause any unusual pain. At this point I put most of my weight on the walker and very little weight on my leg.

Pain After TKR Surgery – Checking Out of the Hospital and Driving home

The first time and only time I experienced nausea while in the hospital was during the discharge process. I let my nurse know and she said that a side effect of Percocet is nausea and that she would get me something to remedy the nausea.

She also suggested an over the counter drug Meclizine that could help me with any future nausea at home. Because of nausea I was unable to eat much during my last meal.

After discharge a volunteer brought a wheel chair and took me to my son’s car. Even though the leg was down low, I did not experience any pain.

Getting into his small car was a bit difficult. At first I tried to get in the back seat in order to elevate my leg. That was not so easy so I opted for the passenger front seat.

With some help I was seated and on my way home. I suggest you bring the biggest most comfortable car you can find for the ride home. I only had a 20-minute ride home during which the pain was not bothersome.

Getting out of the car took some time. I was in the garage so I only had a short walk (no stairs) with my walker to my living room where I plopped down in my reclining chair.

I was happy to be home and I only felt moderate pain at that time. My wife went directly to the pharmacy to fill my pain medication prescription.

Pain After TKR Surgery – The 1st Week

During the first week post surgery I began by taking the Percocet as directed every 4 hours. So many people had advised me to do this and not to be a “tough guy”.

It was good advice but near the middle of the week I began stretching the time in between pills to 6 then 8 hours. By the 7th day I was only taking one pill trying to make it last for 2 of my 3 therapy workouts. At this point I began taking Tylenol (1000mgs) once or twice a day.

The pain was very low, 1 to 3 while resting. At night sometimes I experienced more pain 4 to 5 and took Tylenol to reduce the pain so I could sleep.

The pain was most acute (7 – 9 out of 10) during my physical therapy sessions. Most of the exercises were fairly easy except for 2 range of motion exercises. I won’t kid you, it hurts and it takes perseverance to complete the exercises. exercise after knee replacement surgery - 1 week

The Percocet made it much easier for 2 of the 3 workouts. I was careful and took the pill before a workout and tried to complete the second workout within the 4-hour time span.

My staples looked pretty gruesome but they did not cause any additional pain while resting or while doing my workouts. I kept the incision area covered with antibiotic ointment to keep it from drying out.

During all my post surgery workouts the scar and staples never leaked or split open (because the incision was on my knee I thought bending my leg might cause tearing – but this never occurred).

I used the walker a lot during the first 4 or 5 days. It takes the weight off your legs but can make muscles in your upper body sore. This reason alone is a good reason to work out your upper body before surgery.

As the week progressed the pain definitely decreased. By the end of week one I was taking only one Percocet at the most, prior to daily exercises.

The medication is crucial but the elevation icing and exercises also contribute to less pain.

Exercise religiously and ice immediately after!

Knee Replacement Pain After 1 Week

Everything I read and heard from others convinced me that the physical therapy was important and that it would hurt. I was not disappointed.

The range of motion exercises were tough and they take a lot of self-discipline when nobody is watching over you. There were many times I had to talk myself out of cheating.

I am glad that I persevered. I was surprised that I was up and walking so fast in the hospital. I was also surprised that I had two physical therapy sessions in the hospital.

Related: Best Wedge Pillow After Knee Replacement

After only two days home the home therapist made her first visit and the work began. I saw her twice the first week and each time she added exercises and they became harder and harder to do.

During my first home physical therapy session the therapist measured my range of motion from 180 degrees flat to 70 degrees bent. By the end of the first week I had improved to 78 degrees.

My Tips To Ease Pain The Week After TKR Surgery

Take my advice; don’t try to tough it out.

  • Stick to the medication plan developed with your hospital team.
  • As time goes by and the pain decreases wean yourself off the Percocet. Don’t make an arbitrary decision to stop cold turkey.
  • You will be sitting or lying down initially so elevate your knee. Icing doesn’t always feel good but it dramatically reduced my swelling and pain after therapy.
  • If you can, stay busy, read, watch TV, do puzzles anything to keep your mind off the pain.

Conclusion

In this article we discussed my pain level during my first week after knee replacement surgery. Yes you can expect pain but you can use your medication wisely, elevate, ice and exercise regularly to reduce pain.

Again, don’t try to “tough it out”. Use the amount of medication suggested by your doctor and hospital team to begin with.

As time goes by slowly wean yourself off the narcotic and replace it with (in my case Tylenol) an over the counter pain reliever.

Your pain will gradually decrease the first week. If you want maximum success, suck it up and complete your workouts assigned by your physical therapist despite the pain.  Take a pain pill strategically before your workouts.

Keep telling yourself the pain is temporary and that during therapy the pain is a good indication that you are making progress. Pain is no fun for any of us but we are fortunate to live in a day and age were medicine and other techniques (icing and elevation) can help reduce and minimize pain.