Pain Management After Total Knee Replacement
By Matt Paulus, MS, ATC
Pain after Total Knee Replacement
Pain is a major concern for many patients after a total knee replacement. The surgery takes a large toll on the body, and for this reason, one cannot expect to resume his or her regular daily activities right after surgery. The damage caused to the knee joint happened over time; therefore, healing and recovery will also need to happen over time. Pain, swelling, and over-activity are all related. The remedy to all three is rest.
The knee is the biggest, most complex and nerve-rich joint in the body. When overused, the knee will react sharply, causing discomfort and pain. Instead, one should try to be active in short spurts and rest for longer periods of time in between. As the knee feels stronger and has less pain and swelling, one may try to increase his or her activities, as tolerated.
After your knee surgery, your orthopedic surgeon will most likely have you on narcotic pain medication. You can expect to be medicated for at least a few weeks. As with all narcotics, there are side effects, therefore one should follow the instructions exactly as they are prescribed. The importance of medication is stressed for one simple reason. Pain causes swelling, which can interfere with your physical therapy, your healing, and your progress. At lower pain levels, the medication your doctor gives you will work more quickly. However, the more the pain is permitted to build up, the longer the drug takes to become effective. Weeks after the surgery, you may still need pain pills even though you are getting back to normal activities. This is true especially at night when pain tends to become more obvious. Ice is also essential for pain management in knee replacement surgery recovery. Ice can reduce pain in combination with medication, and with less severe pain, it can be used on its own. Lastly, elevate your legs and rest while you are icing.
It is important to remember that sometimes pain can persist in one form or another for many weeks. This is normal. In addition, your physical therapy may cause some pain in your joints. You can prepare yourself for this pain with a dose of medication about an hour before your physical therapy sessions. Educating yourself about pain before you are in pain can significantly reduce fears and help you manage your expectations. Follow a simple mantra when practicing pain management for total knee surgery:
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