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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 staff 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 an 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.
Related: Asprin and the Best Medicine For After Knee Replacement
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
My 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 surgical 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 suggest you have someone with a medium to large car pick you up from the hospital. 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. (Meclizine)
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. 
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 where medicine and other techniques (icing and elevation) can help reduce and minimize pain.
Hi Ken, I just finished reading your experience of your knee replacement. I found it very informative. I’m 76 and I’m having tkr surgery on march 12. Of course it’s scary knowing the pain that’s coming, but you laid it out great as to the best way to handle it. I feel much better knowing what to expect and the the plan of attack. I’ve heard stories about people who get hooked on the pain meds and I do worry about that, but i know i will need them. I’m more worried about the recovery than the surgery. Anyway, thank you for all the good advice. Maybe I’ll document my experience too! Hope you’re doing well.
Sincerely, Sandra Hores
Good to hear my blog has helped provide some insight to the process. You’ve got a solid month to prepare. If I could go back I’d concentrate on my weight and leg strength prior to surgery and I’d remind myself to work hard for at least 8 weeks post surgery (sometimes I didn’t feel like it but I did anyway). Yes, the pain meds are a serious issue and I used my sparingly, however, I always took one before doing my exercises in the first few weeks. I transitioned to OTC meds pretty quickly but the prescription meds will help you stay more active early on (don’t try to tough it out). Wishing you a speedy recovery!
Hi Ken,
Thank you for the valuable information that you have provided for anyone undergoing TKR surgery. I read this article and another article you posted, and I found them so helpful! I am having knee replacement on March 24th in a Boston hospital. I am dreading the recovery, but I am at a point where I am in so much pain, especially going up and downstairs, that I no longer have a choice. After the right knee, the left knee will need to be done. I will definitely follow all of the tips and suggestions that you have provided. Thanks, once again, for such well-written articles!
Thanks for the feedback. Glad my experience can help. Get yourself in good shape going into surgery and recovery should be a little smoother. Expect the first 2 weeks to be tough, but be diligent with your recovery exercises. Best wishes!
Hi. let me add my thanks Ken. I am having surgery on February 11 and the information in you have provided is very helpful. Hoping to be back on the golf course in May!
Thanks for the kind words. If all goes well and you work hard in the first few weeks, you’ll be chasing par in 2 months! Best wishes with your recovery.
Thanks loads for documenting your journey. I am now 23 days po from tlkr and I’ve been reading your journal, sometimes several times over. Although everyone recovers at different rates, reading your blog makes me feel that I am on my way to recovery. I can also relate to some of your comment, e.g. wanting to cheat on your exercises. So, thank you for documenting and providing your experiences especially for those who, at times, been discouraged.
Thanks for the comment. Sometimes I wonder if I’m helping people or scaring them regarding the challenging recovery process. Staying active/moving is counterintuitive after surgery because we want to rest and allow our body to recover. I still feel my best improvements were in the 1st 8 weeks after TKR. Hope you continue to improve just as I have!
Hi, thank you for your very informative blogs. I had PKR 19th December. Was in hosp. 4 days. By which time I was vomiting and in bed (I couldn’t or feel like exercising) Lasted until Christmas Day when I was back in hospital. In there 3 days and back home. I felt ill for another week . The only exercises that I could manage was foot rotations and pressing the back of my knee into the mattress often. Could only lay on my back. I managed To get back on track walking, no need for my crutches to help me up and down stairs. The only pain is because of the knee joint and muscles putting themselves right again. Best thing to have your knee op. Now I know the other one needs doing 😕
Sorry to hear about your initial set-back. We all respond differently so that’s why it’s important to follow doctors orders. Good to hear you’re back on track and feeling better. I experienced the same thing with my muscles and ligaments adjusting to the new (correct) knee position. Stay moving and thanks for reading!
Thanks so much for your very informative blog. My TKR is on April 15th having been changed from March 6th. I’m in the UK so will be interesting to see any differences, one huge one is that I will be awake throughout the surgery, not looking forward to hearing the hammering and filing that I saw on a recent live TV programme of a full 2 hour knee replacement.
Your blog has given me hope that I can get my life back again, thank you.
Hi Melanie, glad you’re finding my blog helpful. Looks like they moved up your operation – I just hope you had adequate time to prepare. You’re correct, being awake for the surgery will be a much different experience than mine (I’m sure your doctor and you have your reasons for doing so). Watching the operation on video can make it seem scarier than it needs to be. I was surprised and relieved that when I woke up I didn’t even realize I had the surgery, although I soon felt the swelling and a little uncomfortable. My surgery was faster than I expected and I was home the next day. The therapy was tough for 2 weeks but the medication helped and the hard work paid off. Have a longer time horizon and stay active. Let us know in a few months how you’re doing!
Ken, like so many others I want to say “THANKS” for all the detailed information you have provided. I read everything you posted and will re-read it a few more times before my surgeries. The products concerning the bathroom will be a big help. I am scheduled for June with the 2nd TKR for Oct. which falls nicely into your recommendation of timeframes. I also read about developing “bowing” which is something that has occured with me and wonder if that is corrected with TKR surgery. I have put this off for too long and while very nervous my quality of activities has been diminished by my delay. Looking forward to great hiking with my husband ahead. Again thanks. Karen
Glad my experience could help, although everybody has a different situation. You have plenty of time to prepare for the June surgery – the better shape you are going in will help with your recovery. I also had bowing and my surgeon said he’d “fix it”. I thought he was joking but my leg is much straighter now. Maybe you’ll get the same improvements. If you’re an active person I bet you’ll have a speedy recovery. It’s common to want to rest after surgery due to the wound and pain, but I really believe that moving (walking and bending) during the first week was essential for my range of motion. I found I got the greatest improvement of my range of motion during the 1st month. After that, the joint sets and gaining range of motion slowed down. Work hard, ice, elevate, and use the pain medication to help you workout.
Laying here in bed with leg elevated and iced! 10 days post op from TKR. Found your story interesting! Noticed you were given Percocet. I am on hydro cod one-acetaminophen. Wondering what determines what you are given. By your description , to me it sounds like your pain levels were a lot lower than what I experienced! My description of putting pressure on bad leg- “hot horrid hell” with lots of swelling to boot. I would not want to “blanket” statement pro or con because everyone’s case and doctor are different!! Plus my pain tolerance is looooooow!! Nice to compare tho. It’ s a slow recovery! If you are looking TKR in the face be prepared – it will be painful – take your meds and if it’s not enough- Speak Up! Good luck! I’ m hoping it will all be worth it!
Glad you had a chance to read through my experience. I always make sure I’m not giving medical advice, but I’m happy to share what I went through. Sounds like your recovery is going well, with no shortage of pain/swelling. I’m not sure about the pain meds, but I know I was advised to take them right before my physical therapy sessions so I could work hard. Thanks for sharing your thoughts on the early days after surgery. The first few weeks were tough but I started feeling much better in the second month. Hope it goes well for you!
Really liked being able to read all of your journeys……..mine will begin on June 10th …. now don’t flip out but I am having both of my knees done at the same time so it will probably be just a little different. Here’s hoping I do as well as all of you! Wish me luck will get on and let you know if that’s ok
Two surgeries are a little more complex than mine. I’ve heard from a few people who did the same as you and had both done at the same time. At least you get them over with! You’ve got some time to prepare yourself. Let us know how it goes, thanks!
Hi Ken,
I am 5 day out from my TKR and hanging in there. I purchased a motorized ice cuff and that was worth the $. My Dr. does not use the passive motion machine so rehab is with therapist and on my own. Well thats not entirely true as I have the most wonderful husband available for my every need. Had one set back the day out of the hospital as I was having a-lot of bleeding in the bandage so that evening went back to the hospital and had a Prevena Plus put on. Its a small pain in the butt pump that diverts the blood into a container. Very inconvenient to have as the long tubing seems to get in the way every time I get up. Let move on to pain as yes it is there steadily at a 4 or 5 with a 7 after therapy. I am very flexible but to not be able to pull my knee up close is discouraging to say the least. Hopefully when I get rid of this machine and all the tubes, bandages and container I will be more flexible. 2nd knee is scheduled for Oct. 9 but I might have to think on that. Thanks for you blog its great.
I didn’t use the passive motion machine either but I’ve heard that some people do. Glad you’re hanging in there. It gets better quickly but be patient and work hard!
Hi Ken,
I had mine on July 5th. 67 years old, active guy, mostly weightlifting and rowing. They had planned on doing this as a day surgery…..that didn’t fly. Stayed overnight. Went home with a pain pump, oxycodone, Tylenol, Meloxicam. Second day post surgery I had in home therapy following the hospital provided session the day before. Got the knee flat and bent to 90 degrees which I was pleased with….but that day’s pain level was very high. Had another PT session today. Ice machine and elevation helps and today is better! PT is very hard but needed, my athletic background is a big help I think. Your blog is the best resource out there…..by far. Thank you so much. You have answered a ton of my questions!
I want to thank you for documenting all of this. I am due to have TKR sometime in next 5-7 days (insurance delays). I had an osteotomy (cut quadriceps muscle and realign the knee) 20 years ago on my opposite leg so I recall some similar experiences with your recounting your experience. I know technology has changed in that time but to further complicate, I now work overseas and will be having the surgery there. Even if the doctors speak OK English most of the nursing staff doesn’t, (hoping hospital PT staff does!) and the doctors aren’t used to having to answer all the questions Western patients ask. Thus your blog has filled in a lot of the missing pieces.
Has anyone experienced Sciatica nerve problems? I was progressing smoothly till day 8 then started feeling the Sciatica act up during the heel slides & chair/floor slide activities. Pushed thru it for a couple of day which I now realize was wrong because I am now down with a full blown problem. Dr. put me on Prednisone which is suppose to help the inflammation and I am going thru the heavy pain meds (Oxycodone) steadily. Barely touched them before. Feeling bummed because I am now losing ground and it hurts to do anything. Feeling sad 😂
Karen, I am 4 weeks out of my second TKR and I’m here to tell you the sciatica problem is holy hell. I did very well with the first knee until I pulled my hamstring and had sciatic pain as well. Ask your PT for any exercises you can do to help with the sciatic nerve. Mine gave me several easy routines in addition to the knee therapy and they really helped. Took time though. Be patient (I know easier said than done) but it does get better if you continue to exercise and address the issues as they come. My second knee pain has been more “ache” than anything. It seems to change each day and often feels like muscles and nerves readjusting. Good luck, and be well. It’s worth it. I wish I had found these threads before I had my surgery. Thank you Ken! This is so very helpful.
Thanks for your information. Sciatica pain at least let the knee pain come in 2nd.
Thank you so much for documenting your surgery and recovery. I am scheduled for TKR in 2 weeks. I am nervous of course, but reading what you experienced was extremely helpful. I am a life long athlete so I am preparing by doing quad exercises, swim workouts with my masters swim team, body and core strengthening exercises with weights and bands, and stationary cycling. You wrote about needing strength for using the walker, getting up and down, etc. lots to prepare for. Clothing and shoes I had not thought about! Great tips! Very helpful!
If you’re strong going into surgery, I’ll bet you’ll have a speedy recovery. Best wishes and thanks for visiting.
Hi Ken, a really interesting blog thanks. I am 48 and have my TKR booked in for next Tuesday. I am hearing/reading a lot of good things around how quickly you can get back from a TKR. My sport is golf so am hoping to be back playing by March. I have seen the operation on TV (not sure that was wise) and it looks pretty brutal. I wondered if there was 1 or 2 things that were more important for you than anything else after the op, what were they? cheers Simon
Hi Simon, if all goes well you’ll be on the links in no-time. Looking back, the most important thing was movement and flexibility in the first 3 weeks after surgery (these are also the most painful weeks). Best advice I received was to take a painkiller before doing the exercises so you can really bend the knee and keep the scar tissue from forming. I was sore the next day, then I took the pain pill and did it all over again (bending, strengthening) multiple times a day. Don’t forget to elevate, ice, and massage the joint as well. It’s tempting to be sedentary and “rest” in the weeks following surgery.
Fantastic information Ken! I am at 100 days post TKR – exercising every second day, rest the other. Still strong pain the next day, if I’ve done too much.
My TKR was in Australia and it is the norm to load us up with 2 types of Oxycodones – a slow release and a quick release. I got sick of the drugs & lack of sleep and just went cold turkey. It was really foolish, as I suffered withdrawls – so I have slowly weaned off. Only on Ibuprofim/Tylenol now when needed.
What is your fully recovered knee angles now?
I can straighten all the way. Around 120 degrees bent, which is probably similar to before surgery, however, with 0 pain now!
Ken, thank you! I’m 4 days post partial knee replacement (patello femoral joint) and your blog will be my ‘go to’ guide
for keeping me on track and encouraging me to stick at the range of motion exercises. I know it’s going to be hard but, for now, this knee is my full time job so I have no excuses not to get on with it. All the best to you.
Thanks for the comment! All I can say is work hard the first few weeks and push yourself with your range of motion. It’s a painful period of time but the hard work and activity pays off!
Having a bilateral knee replacement on March 12th. The information you gave is good to know! Just a little nervous. More excited cause I at least know the knee pain I will have after surgery will eventually go away, unlike what I am experiencing now. It is so mentally and physically draining!
Thanks for all of the advice.
First 2-3 weeks are very important. Don’t slack on your physical therapy and do it at home on your own as well. Some great advice I received was “take the pain pill before physical therapy so you can push yourself”. Best wishes and thanks for reading.
This Blog has been very informative – I live in France and am having a TKR on the 2nd March 2020 and then being moved to re-habilitation unit for 3 weeks (this is the way they do it in France).. I am 58 years old – Had an Osteotomy done 9 years ago and the pain was horrendous – I was on crutches for 6 maths – Your writing has helped me be less panic stricken about having a TKR.
3 weeks of rehabilitation sounds like a great option to have. Hopefully they keep you moving and get your knee bending as soon as possible (the had me bending my knee the same day). Given you’re in good health, you’re at a good age to bounce back quickly. Thanks for reading and best wishes with surgery.
Your blog has done much to ease my anxiety about the pain and pain meds, as well as initial mobility. I have lost 10 lbs so far and had about 6 weeks of PT, with some improved measurements. This all coincided with Covid19, which, in a way has worked out fine since there wasn’t much else to do or go out for. However, the stresses of a pandemic and the prospects of a tkr, which was totally unexpected and outside even my worst dreams, has become too much. So I am hopeful I can get scheduled into something so the heavy lifting will be mostly over in time to enjoy Christmas, such as it may be. This waiting and dealing with such reduced mobility, and daily pain around 5-6 has taken its own toll. But I have a well educated and well trained surgeon, who’s easy to work with. Again, you offered a first rate look from the patients corner and I thank you.
Glad it could help! And thanks for the comment!