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Managing Postoperative Pain, Swelling, and Bruising After Total Knee Replacement

 

Understanding side effects

  1. General pain may occur for up to several weeks following a total knee replacement.
  2. Swelling typically lasts for 2 to 3 weeks after surgery, but may persist for as long as 3 to 6 months.
  3. Bruising may last for 1 to 2 weeks following surgery.

Postoperative pain, swelling, and bruising are a normal part of the recovery process following knee surgery. However, there are ways to manage the pain and ease your recovery.

Keep reading to get tips on dealing with these common side effects of surgery.

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After the operation

Immediately after the operation

According to Massachusetts General Hospital, surgeons may put novocaine in the knee to help with pain for the first few hours. After this wears off, you might receive pain medication either orally or through an intravenous tube. These medications may include a strong opiate or opioid such as morphine, fentanyl, or oxycodone. There’s little chance that you’ll become addicted to these drugs, because they’re used only for a short period of time.

Pain medications

Medications to manage pain

Most people will take oral pain medication for up to several weeks. These include prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. If severe pain persists, your doctor might prescribe stronger pain relievers such as tramadol (Ultram) or oxycodone.

You may need over-the-counter (OTC) medication to help reduce temporary pain and inflammation later on. These medications may include acetaminophen (Tylenol) and NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Your physical therapist may provide massages and prescribe exercises to help reduce inflammation. The pain will likely diminish over a period of several weeks.

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Swelling

Managing swelling

Swelling is also a normal part of the healing process. It’s likely that you’ll experience some swelling for 2 to 3 weeks following surgery. You can reduce swelling by doing your postoperative exercises. Elevating your leg on a pillow in bed for 1 to 2 hours each afternoon will help swelling as well.

According to the American Academy of Orthopaedic Surgeons, swelling can last for 3 to 6 months after surgery. It’s a good idea to invest in an ice pack. Ice packs are very effective for reducing swelling and inflammation in your knee joint and the surrounding tissue. It’s generally recommended that you use an ice pack 3 to 4 times a day for about 20 minutes each time. Get a recommendation from your physical therapist or doctor if you see no improvement, or if you think additional icing might help. After several weeks, you may also benefit from applying heat to your knee.

Bruising

Dealing with bruising

Bruising around your knee may last 1 to 2 weeks following surgery. Bruising is typically a purplish discoloration that indicates blood in the area. It can also cause additional tenderness. You can reduce inflammation and bruising by elevating your leg.

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Home treatments

Home treatments

You’ll most likely wear compression stockings while you’re in the hospital and then while sleeping for up to six weeks afterward. These socks will reduce the risk of developing a blood clot and may help reduce achiness in the leg.

Topical creams and patches applied to the knee can also help reduce pain and make it easier for you to sleep at night. These usually include active ingredients such as capsaicin, menthol, or salicylates. These ingredients are well-known to ease pain when they’re applied on the skin.

Read more: Natural home remedies for knee pain »

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Physical therapy

Physical therapy

Your physical therapist may use a TENS unit to stimulate blood flow and reduce pain to your knee and the surrounding area. TENS stands for transcutaneous electrical nerve stimulation. These devices deliver electrical currents to the skin and may reduce nerve pain. According to a 2014 study published in the journal Pain, TENS is not effective for everyone. People with high levels of anxiety or pain catastrophizing were less likely to benefit from TENS.

Your physical therapist may also provide massages or show you how you can stimulate the muscles and tissue surrounding your knee.

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Exercises

Follow your exercises

Make sure you do all of the exercises your physical therapist prescribes. These exercises help strengthen muscles, increase your range of motion, and increase blood flow around your knee. This promotes healing and helps drain fluid away from sore tissue.

While exercising can help postoperative pain, it’s important to avoid certain positions that can cause damage. According to the Cleveland Clinic, you shouldn’t squat, jump, twist, or kneel after surgery.

Takeaway

Takeaway

Pain effects individuals differently, and there are many factors that can change the way you perceive pain or discomfort.

You should discuss your level of pain and inflammation with your medical team and report any abrupt changes. The proper use of medication and therapy will help you reduce discomfort and speed up your recovery.

Learn more: After total knee replacement surgery »

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