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Treating Pain After Total Knee Replacement Surgery


Have you had a Total Knee Replacement surgery (TKR) and are experiencing pain?  Unfortunately, you’re not alone.

At least one out of eight patients report pain a year after surgery, and some studies say this its almost one out of five.

The pain tends to develop.  Patients report limited pain for the first three months, while strong pain medication is used.  For some, however, reducing the pain medication doesn’t coincide with a decrease in pain, which may even increase.

Local treatments

Analgesics, or painkillers, are often used for TKR associated pain.  Many prefer not to take oral medications that are systemic in nature and so choose local treatments.

Localized patches that dispense pain medication are an option.  Capsaicin and other creams are also commonly used.

Massaging the painful area may help prevent desensitization.

Alternative therapies for pain

Meditation and other alternative treatments like hypnosis have shown some – but limited – help with pain management.

“Antidepressants” for pain

Your doctor may consider prescribing a medication commonly known as an anti-depressant.  While they certainly serve that function, they also have pain reducing effects in doses lower than those used for depression.

Tricylcic antidepressants tend to be more effective than SSRIs like Prozac, but they also tend to have more side effects.


Figuring out what is causing the pain takes proper diagnosis.  Unfortunately, that means more imaging and testing.

Some questions to help figure out what’s going on:

1) Is the pain sharp or chronic?
2) Does it occur during a specific activity?
3) Did the pain exist before surgery?

Sharp pain, for instance, tends to indicate a mechanical issue, while chronic pain may indicate infection or other issues.  Signs of infection include chills and fever, and should be treated immediately.


One of many possible complications is the presence of a neuroma, or an overgrowth of nervous tissue.  Treatment consists of selective denervation and has a high success rate of around 86%.  Side effects are common, too, unfortunately, but tend to subside over 3-6 weeks.

Fast and Safe Pain Relief


The management of patients with painful total knee replacement

Evaluation of patients with a painful total knee replacement

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This post was written by on Thursday, July 23, 2009. This author has written 223 posts on this blog and has 6187129 total posts views.

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  1. I had my surgery a year ago, Nov, I just saw the doctor for my 1 year check up, I also have seen him several time in between all this time, for a horrid pain behind the knee that I had the TKR (left leg) this pain in on the back of the knee right by the inside on the leg. It can not be touched, at first the doctor thought it was a blood clot, as I have a history of them in that leg, after 2 days in the hospital, nothing, I’ve had x-rays, scans, still nothing, it hurts so bad when it’s touched, just sitting on a chair with a deep seat and car seats pulls at it and the pain flairs up, after seeing the doctor last week, and he touched that area, and he jumped almost as high as I did, he couldn’t believe it was still so bad. After a lot of questions, he is writing my Neuro. doc to see what she can do, this pain wakes me up if my leg is touched in that area. I hope she can help, but reading all these letters, it doesn’t look like they couldn’t help much, but then those that did get help aren’t here to tell us about that. I’d love to hear from you, is this the type of pain you are talking about? I really need to have the rt knee down, I’m walking bone on bone, but told the doc, I’ll put up with it as long as I can, between both knees I can’t do my job or much of anything. I hate being like this, I’ve been a pretty active person up to the surgery.

  2. Richard Sternberg

    I had a Total Knee Replacement at the Hospital for Special Surgery in New York. Two year latter, with at least
    a year of PT. I have been total its a question of muscle coordination in walking to keep stress off KNees.
    At Columbia, Presbyterion they suggested as last resort tendon shaving. Any experience. Any comment.

    P.S. PT says I am very very limber and have strong muscles. that I just need my muscles to work together properly.

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