To have underestimated the pain following knee replacement surgery

[Stiffnewknee]

I’ve just had a total knee replacement and OMG the pain is unbearable! I’m usually pretty good with pain but this is next level! The pain was so intense in hospital that even morphine wouldn’t touch it but now if I’m still then I’m not in much pain which is some progress! I’m on day 5 now and as long as I’m in one position it’s not too bad but the minute I try to move it’s a nightmare! It’s so stiff and difficult to bend making the physio exercises impossible at this stage. I’m trying my best because I know how important they are and I really want to be mobile ASAP. My leg is still very swollen and the biggest problem is pain and stiffness at on my thigh just above the front of the knee and also behind the knee. It’s as if my bone is being ripped off when I try to bend it. I was sent home with coedine and paracetamol every 4 hours and also with morphine to take when required. I’ve tried not to but I’m wondering if I should take it just so that I can make a bit more progress with the exercises. I’m not sure whether it’s best to take morphine and persevere with the exercises or be a bit kinder to myself and try to get the swelling down first. Any advice gratefully received, please tell me it gets better!

Are you doing the regular icing with an ice machine. Don’t under stomata how important that is. Your pain is at a peak, it should start to reduce soon but the ice is your best friend at this point

For clarity, NSAIDs are routinely used after knee/hip replacements subject to the usual contraindications.

I've had both knees replaced. Take whatever pain relief you need, do the physio and ice, ice, ice. If you weren't sent home with an ice pack that straps round your knee, buy one. They're about £20. I acquired a trapped nerve in my thigh post surgery and was told not to use topical painkillers like ibuprofen gel anywhere near the wound so be careful and check with doctor before using anything like that.

It does get better and movement gets easier. I'm 7 years post surgery and it's been life changing.

I am three weeks further on than you and the first few days at home were brutal. I kept thinking I had made a huge mistake to undergo the operation. I would count down the time until I could take the next painkiller, and the only ones that seemed to have any effect were the opioids. I’d also started reading Demon Copperhead - about the US opioid crisis - so that was an interesting juxtaposition!

I could have a maximum of three opioids a day but by the second week I tapered down to two opioids a day and I am now on one a day. It is still painful, the operated knee is still stiff but it is steadily getting better.

It is crucial that you do those exercises now to make recovery easier so yes, do take the maximum painkillers that you are allowed so that you can exercise. Remember it’s only short term.

Do use ice packs to reduce the swelling and don’t ask too much of yourself. The exercises should take priority over day-to-day chores but they will tire you.

Thanks for all of the useful advice. I called the hospital and they said no NSAID for 2 weeks because I’m on post op blood thinners. They also said that while it is a very painful op anyway, my op was complicated due to the issues they found and this can cause more pain. I have been using ice packs but they aren’t doing a lot yet. I have invested in a cooling machine so hopefully that will arrive tomorrow. I’ve also found the FB group. 😊

MIL had this done 5 years ago and flatly refuses to have the other one done. She from the generation of natural childbirth and says she would havevall 3 labour's again than have the surgery again! It will be worth it in the end though.

Thinking of you OP. It's a bloody awful time, but it will be worth it.

Also on the FB group a lot of people get very ott about their 'bends'. Take everything at your own pace and dont compare yourself to others

@K0OLA1D
Thank you. Yeah I’m ignoring the bend stuff, my legs have always looked odd due to the knees not being formed properly. I’m hoping it will be worth it, today has been a better day. 🤞

Poor you. My husband had a knee replacement and said it was painful afterwards and he is very stoic. Take the pain relief that you need and hopefully that will ease it enough to be able to do your exercises. It will get easier.

There are a lot from the states on the FB groups and some get quite competitive over their bends and how early they managed to hit 90!! I was only 29 when I had my first knee and it took me over a month! I still can't get a full rotation on an exercise bike 13 months after my second! But for me, they have definitely improved my standard of living!

I hope you manage to get some sleep. I know how isolating it can be at night when you're in pain x

Poor you.I had a partial knee replacement and that was easily the most painful thing Iv'e experienced .Take all the pain relief you can and do the exercises but don't beat yourself up if you can't do them fully for a day or two if it's too swollen. But ice and elevation are your friends. I used a Cryo cuff and it was brilliant. You gravity fill it with iced water.Each night I froze a small Pyrex bowl of water then put it in the chamber next morning and it lasted all day. I used it for weeks after the op .Especially as I started doing more and my knee ached and was a bit swollen again by evening. I don't regret the op but seriously hope it last me out and the other knee doesn't need surgery!

Knee replacement surgery is one of the most painful things you can go through. If it weren't for the fact that it has such a good outcome with long-term benefits, no one in their right mind would ever do it. Take the maximum painkillers and do your exercises, it really does hasten the recovery time.

My mum had both her knees done, when she came round from the surgery they forgot to give her morphine. She says the pain was so bad she wanted to jump out the hospital window 😨
But now she freely says her new knees are the best thing ever, no more living on painkillers for chronic arthritis, no more falls, etc.

Good luck, and be assured it'll get better every day until it's a distant memory!

Definitely take the morphine. I broke a shoulder bone and weaned myself carefully and quite early off pain relief. The consultant wasn’t delighted and told me to restart it, or I’d make poor progress with the rehab exercises.

Unless you have a history of addiction then just take the morphine. YANBU to be surprised by the pain because from what I’ve seen they’re useless at providing useful information beforehand. Despite repeatedly asking beforehand, only on the day my MIL was being discharged from hospital after a hip replacement did they mention she’d need to have someone at home to look after her. Thankfully DH and I were in a position to just pack up and move in with her for a couple of weeks, but we wouldn’t have minded a bit of notice.

As others have said take the pain killers and keep moving.

Ice is essential - as you weren't sent home with an ice pack that fits around your knee it's great that you've ordered one - keep it in the freezer and use it for 20-30 minutes, then make sure you have a break for at least as long. This will make a huge difference to the pain management and needs to be day & if you're woken by pain at night; you may need more than 1 ice pack if you've not got the ice bucket style/ice/pulse machine so it has long enough to get cold enough.

Also keep an eye on the wound healing, as occasionally there's internal infection which increases the pain - I'm sure that won't be your problem.

Good luck and remember this is short term.

I was told to strictly avoid any NSAID meds post hip replacement whilst on blood thinners

The pain relief, apart from making you feel a bit better, is intended to enable you to do the really important stuff - move.

I had spinal surgery last year and the surgeon gave two instructions - take the pain medication and walk. The latter was made easier by their not letting a patient out unless they could walk and do a flight of stairs.

It worked. After a beastly first week.

I have had both knees replaced with a year gap between each operation. The. Pain was tough and when I had my first knee done I gave in to the pain and avoided moving and doing the physio as much as I should have. This knee is much stiffer as a result. I learnt my lesson the second time around and made sure I did the physio. I found heat pads helped when the pain was bad. It will be all worth it when you can walk well without pain!

Thanks everyone. This evening I also discovered that cooling pads are great for helping me walk upstairs

If they've given you pain meds and you are in pain sufficient that you cannot move/cannot do the physio then for goodness sakes take the pain meds! And take the meds on a regular basis! The whole point is for you to be able to do the movement necessary to keep the joint moving/muscles strong etc etc - otherwise you'll end up in a whole bunch of trouble.

The important thing with post-surgical pain is that you keep ontop of it - which means taking the meds as prescribed, using ice as suggested etc etc. The docs wouldn't have given them to you if they didn't thing you'd need them. As soon as you feel the pain relenting a bit then you can start to take less of the morphine.

It's a shame they don't use nerve blocks more for knee surgery in the UK. At any rate it is what it is: please for goodness sakes do the physio. If you are in too much pain - even if you are taking the pain meds - to do the physio then go to A&E. Make sure you are keeping an eye on things like potential indicators of infection (so, any nasty discharge from the knee, knee is hot to touch, you are feeling unwell/temperature etc etc - you should have been given a number to call at your hospital for the department who did your surgery to call if you had post-surgery issues: CALL THEM!!! They are the ones to contact, not mumsnet. On this site you'll get either people who say it's normal or people who say it isn't- - and that's not going to address your personal situation because no one here has actually seen your knee/can examine you etc etc. Only your medical team can do that.

Different people react to pain in different ways. When I had spine surgery I was in HORRIFIC pain - I had a morphine IV clicker and it took a bit longer to bring the surgical pain under control...but in my case it was because my sciatic nerve was damaged and very inflamed. When I had abdominal surgery I did not need nearly as many pain meds - though for some people that surgery/condition is considered worse than child birth. Everyone is different.

Unusual to be given ibuprofen after surgery: it can have blood thining qualities and cause bleeding - so it would be unusual to have directly post surgery when there are still open wounds. Far more likely to be prescibed paracetamol with codeine. Please don't suggest that people take ibuprofen/NSAIDS or indeed any other drugs post surgery unless it's been prescribed by their medical team - none of us on this page are equipped to give medical advice over a forum page.

I had my knee replaced a few years ago. As you say, the pain is excruciating. Don't leave it too long to have your staples removed because that is also painful and they get tighter by the day. Also try and put some kind of moisturiser on your scar.

They can definitely be used together, but might be avoided if there are particular concerns about bleeding or the implications of bleeding in the context of the operation being done so it’s a case-by-case decision.

This!!