After Joint Replacement, When Will My Pain End?

From a presentation by:
Rodney Alan, MD
McLeod Orthopaedics

For most recipients of a knee or hip joint replacement, the elimination of chronic pain or discomfort is a major benefit. There is some pain after the procedure and McLeod Orthopedic Surgeon Rodney Alan, MD explains the kinds of pain you might have after surgery and when it will go away:

Here is an overview of Dr. Alan’s remarks:

Have you been on pain medicines for a long, long time before your surgery? That is important, because, over time a body gets used to pain medicine. If you’ve been on medicines (Percocet, Lorcet, Fentanyl patches, Oxycodone, Dilaudid) before having a major surgery, it is going to be very difficult for you to overcome the postoperative pain from the surgery itself.

It is similar to a person who drinks alcohol. If at age 21 you go out and get your first drink, with one drink you’re probably feeling a little bit buzzed. For a 45-year-old man, who drinks a six-pack every weekend or every other night, it takes more of the substance to give him the same effect, because his body is used to the “medicine.”

The same thing happens with medicines we call “opioids,” such as those mentioned above. All of those medicines cause permanent changes to the way your body perceives pain. If you’ve been on those medicines for a very long time, it’s going to take longer for you to recover. It’s going to take longer for the pain to go away. You’re going to need higher doses of pain medicine immediately after surgery.

The next thing to consider is: How much to do you weigh? From medical studies, we know that from patients who have knee replacement, the less heavy patients will have less pain, do better and recover faster after surgery.

So, when your doctor says, “I want you to lose weight, it will help you and help eliminate arthritis pain,” he’s not saying that he’s not necessarily going to do surgery. He’s saying that whether you have surgery or not, you’ll have less pain if you can lose some weight.

 Also, the knee and most other joints in the body function as a lever. Across levers, you generate a tremendous amount of force. One pound, two pounds, five pounds of weight on your body makes a big different on your knee, because that force is magnified by that lever action of every joint in the body. The knee and the hip have large levers but every joint in the body functions like a lever.

And the last question: How severe was your disease?  If someone with severe arthritis has a joint replacement, they’ll experience very noticeable difference in pain relief. They’ll have significant improvement and notice it much sooner than someone who only had mild arthritic disease.

Acute surgical pain usually goes away at two to four weeks. That’s the period of time when almost everyone will need to take the opioid pain relievers mentioned earlier. Beyond that you’ll still have some soft tissue pain. After a knee replacement, your knee will feel warm and look red and swollen for about two to three months. Stiffness and soreness usually lasts three to six months before gradually subsiding. You’ll have full recovery about 12-18 months after your surgery.

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