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How to Minimize Knee Replacement Pain

Knee replacement pain is highly subjective. What one person experiences as a 5 out of 10, another person would say is just discomfort.

Despite this very real dynamic, the recovery process following a total knee replacement is generally still regarded as a painful process. Many people want to know “How long does the pain last after a knee replacement? ” Below, I am going to teach you the top three secrets of minimizing knee replacement pain so that your rehabilitation will go as smoothly as humanly possible.


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Push Hard With Range of Motion During Your Hospital Stay

You will never be more medicated than the first 24-72 hours after surgery. Use this to your advantage by pushing your range to at least 90 degrees. If you make that your goal, you will have saved yourself quite a bit of suffering and effort later on when the pain medicine is not so strong. And while this sounds like a relatively simple piece of advice, it can be problematic in surgical units where physical therapy consists of making sure you can walk properly with your walker, go up/down stairs and get in/out of bed safely. In this atmosphere, range of motion is not the focus They are leaving that work for you to do later. This is a critical mistake and will most definitely lengthen your rehab time.

You will add about 1 week of struggle for about every 10-15 degrees less than 90 degrees that you achieve in the hospital. So let me give you an example. If you leave the hospital with 80 degrees compared to 90 it will take you about one week longer to get your full range of motion back. if you leave the hospital with only 60 degrees range of motion, it might take you 2-3 weeks longer. Are you getting the point? Low or no range of motion push in the hospital should be avoided at all costs if a speedy recovery is a necessity. Get out of the gates fast and save yourself weeks of recovery time and less pain and suffering.

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Take Your Pain Medicine as Prescribed For at Least the First Two Weeks

This is the one piece of advice that gets resisted the most! In some limited cases, people really don’t tolerate taking narcotic medicine and I can sympathize with that. it is very hard to want to take the medicine and do your exercises if every time you sit up, you are getting nauseous. But that is only about 5% of the population. If you are resisting because of real or potential threat of constipation, I say, “That is what a laxative is for!”. Most orthopedic surgeons will put you on a laxative prophylactically so you don’t run into trouble. Here’s the bottom line- you’ll be trading off a HUGE advantage for getting over this surgery with the least amount of pain, in the fastest way possible, just so that you will not be constipated. This in my opinion is a very poor trade off. The best way to relieve knee replacement pain is using the pain medicine as prescribed. Bilateral knee replacement pain is solved in the same way.

Remember, the knee replacement surgery is considered trauma by the body and it initiates a chemical process that predictably follows trauma. This chemical process causes constant pain at rest and aggravation of pain with all movements. This is similar to the way you felt after having sprained an ankle or having broken a bone. This is what is going on in your knee following surgery. This pain will not stop until those chemical processes are abated. And guess what, if your knee hurts this badly you will not do your exercises.

Most of the time the reason given for not taking pain medicine is the fear of getting addicted. Again I can sympathize but…my goal, because I am definitely not a pill pusher, is to get you off the medication as fast as possible.

In my experience the most painful task following total knee replacement is getting your knee range of motion back. People who don’t take their pain medicine or do not take them consistently take a lot longer to get their range back and end up being on the pain medicine for longer duration overall.
This also has the unforeseen negative effect of patients feeling like it is taking forever to get beyond their surgery. Bottom line here is…take your pain medicine consistently for at least the first two weeks to give yourself a great start toward a fast and minimally pain filled total knee replacement recovery.

Don’t Emphasize Walking Too Far or Walking Without the Walker For at Least the First Two Weeks

I see a lot of patients making this mistake.They think that it is a victory or major progress to get off the walker as fast as they can. The main problem with this misplaced emphasis is that it will actual work against you advancing your knee range of motion because it tends to cause more swelling and pain. So the more you walk and especially walk without your walker, the more your knee stays swollen and painful and the less you want to bend it

Early on you have enough chemical pain to be worried about without adding weight bearing forces and more pain into the equation. Weight bearing is placing a lot more stress on those bone endings than working on the range of motion in your knee. You’ll be doing plenty of walking later, but I recommend using the walker for the first two weeks and transitioning to a straight cane after that. And when I say using the walker, I mean taking some weight off your surgical leg and putting it through your arms and upper body into the walker. If you are standing up straight and simply pushing the rolling walker in front of you without putting any weight on the walker, you are NOT using the walker properly and will defeat the whole purpose of using it.