How To Manage Pain Following A Total Knee Replacement.
On a recent #asknicole question the patient asked how to manage pain. She was three days following a total knee replacement.
Often when people first have surgery their expectations don’t often match reality. Although joint replacements outcomes are often good in the long run they can sometimes be a bit painful just after the operation.
They Have Done A Lot Of Work In There!
Of course, the consultants have done a lot of work inside. They may have used sutures or staples to bind the wound. You need to monitor any excessive swelling, redness or pain which may indicate infection. If you have any suspicion of infection call your consultant’s secretary and book in for a wound check.
Watch Out For Infection
According to the American Academy of orthopaedic surgeons only one in every hundred people who have a hip or knee replacement will develop an infection. Risk factors for infection include poor sleep, poor diet and smoking. Do your best to try and control these and get eight hours of sleep a night, eat healthily and reduce smoking.
Early Rehab Is Key To Prevent DVT And Mobilise
It is important in the early stages of rehab that we get the knee moving once advised by your own healthcare professional that you are ready too. In a typical total knee replacement they get you out of bed day one. If you have had a nerve block of the leg we will need to wait until you can use the muscles before getting out of bed.
Take Pain Relief Regularly
It is important to take pain relief regularly. Gentle exercises can help increase the circulation and reduce your risk of DVT. Many people wait until the pain has built up before they take pain relief. This is a mistake as it will take longer for the pain ready to kick in. Always seek advice from your pharmacist or your doctor in regards to medication. Some people will use nonsteroidal topical cream however make sure this does not go near the wound.
Avoid Pillow Under Your knee For The Whole Night If Possible
It is tempting to sleep with a pillow beneath your knee, most people prefer it slightly flexed. Although this can be a good way to get comfortable we do not recommend it for the long term as it can prevent the knee straightening. As with anything you will need to use your common sense. Weighing up the option of a good nights sleep because pain is well managed versus difficulty straightening the knee in the morning.
Other ways you can help to reduce pain is by exercising regularly throughout the day and having pain relief 30 minutes before exercise. The knee will often be stiff in the morning after you have been using it. I would recommend purchasing a toilet raiser to reduce the pain when you’re getting up from a low seat. Another neat trick is to put your leg out straight before you sit down. Sometimes the flexion of the knee is too much as you descend.
Return To Work
Many people are keen to return to work. It is important to remember to take pain relief regularly. Make sure you time regular breaks and keep your leg up on a chair with a pillow beneath the knee when sitting. This will help to reduce the swelling.
We can often be irritable when in pain. Sometimes it’s better to take slightly longer off work to focus on your rehab and recovery. It is not uncommon for people to feel quite fatigued. Most people return to work around 6-8 weeks post op for a sedentary job and 12 weeks for a physical job. Everyone is different and this decision should be made on a case by case basis with your healthcare professional.
How Can Physio Help?
Physiotherapy can help you build confidence and strength in the knee.
Early guidance can help you start putting weight normally on the knee again I get you will feel sticks as soon as possible. Exercises should focus on knee and hip control.
If you are wondering if physio can help you why not book a discovery call? This free 30 minute cool with a charted physiotherapist will answer any questions you may have and see whether physio- could help you.