Weaning Off Pain Medication After Total Knee Replacement: how & when

[@junepearl7993]

These videos are the best I’ve found on the internet. I talk to my doctor and PT about her information and they always agree with her. She’s very reassuring, which is so helpful. It’s easy to get discouraged and depressed in this process. It’s long and difficult. Hang in there everybody!

[@dr.samanthasmith]

Thank you June!! That means a lot to me.

[@KiwiLee-fg2mg]

Thank you so much for doing this video! I really needed to hear it being 4 weeks post op and worrying about my pain meds. Your info helped to calm me down and relax a bit!

[@buttedragon]

Same!!!

[@geraldarcuri9307]

On NORCO every 8 hours on discharge. Wasn't enough at first. Every 4-6 hours took me through day 10, post-op. Too much nausea, though. Physician switched me to Uktracet ( Tramadol + acetaminophen ) every 4 hours. No nausea, took me to day 20 with plenty of pain relief, even as I tapered to every 8 hours by day 16. At day 21, I am using acetaminophen and ibuprofen prn with total daily limits set by my physician. Even though my nightime pain doesn't require much pain medication, I have found - as with prior major surgeries - that there is a lingering effect of sleeplessness caused by opioid/narcotic withdrawal, even if you have weaned off it. It's a small price to pay for getting off the heavier prescription meds, and it is temporary.

[@kathystclair9485]

I was prescribed 4 tramadol a day. I took 3 a day for around 3 weeks. Then I used one for outpatient PT. When I was done with PT, I would cut the pill in half and take the half for around a week, then a half every other day. Then I spent a week taking one fourth for about a week. Then a fourth every other day for about a week. I had to experiment in the beginning with the best thing that would help me to sleep. Found for me gabapentin was the answer. I am 3 months PO now. I still have pain, discomfort, and a lot of stiffness. I still do my exercises every other day as prescribed by my PT at home and some sort of stretching every day. I take Ibuprofen and Tylenol. With that being said, I had a total of 5 weeks' worth and only used a total of 3 weeks. There are days I am tempted to take one when I have a harder day, but for me it is the addiction aspect. I have seen too many people go down this road with surgery, can't get any more from their doctor and go to the streets to buy harder stuff. Pain is scary, but addiction is scarier!

[@shanemichael3925]

I’m 23 days out from T.K.R stopped taking narcotics day 18 and doing well other than the early am when the knee starts getting sensitive sensations which keep me up, but even with oxy and tramadol I was having same issues. Trying different suggestions from icing to walking around for awhile or finding different location to sleep, so far none of it works,😢. Other than that doing great maxed out range of motion with 140-145 %, and not having much extra swelling or pain with PT increasing workout. Best wishes to all.

[@dr.samanthasmith]

Range of motion numbers are great! Congrats! I would say at 23 days post op, your discomfort levels should be at their peak. Especially bc you are getting back to normal life again- that means more pain

[@rickthebaker9379]

Wow, my OT gave me 5 days worth. This was my second tkr and was in a lot of pain. I had 15 percocets from my previous replacement and when they were done I was in a lot of pain.

[@dr.samanthasmith]

Yikes! That is not enough for some people. I don’t know how they expect you to function and do PT with just 5 days worth

[@rickthebaker9379]

@@dr.samanthasmith I totally understand their concern with addiction but knee surgery is one of the most painful things that you can experience.

[@trentnaumann8121]

I can’t find the link to your facebook group. Could you provide the link?

[@ebglock]

The 1st thing should be pain levels. My physical therapist will not even discuss pain meds as they can not prescribe.

[@dr.samanthasmith]

Yes, we have to say “take as prescribed” but I often tell my patients “typically patients do this…”

[@asharp6591]

I’m 11 weeks out and still taking one pain pill at night. No meds during the day. Some nights I don’t need it and some nights I do. It depends on the PT I did that day

[@rjxjsbuz6290]

My Dr. gave me 10 oxycodone 5mg and i had those gone in 3 days.....i am a recovering addict and i felt like i could have used more but i chose to deal with the pain i think it might have set back some because the pain was excruciating to do exercises im 3 weeks post op and the swelling and stiffness is still there i ice alot ROM is at 105° and im haveing a hard time getting my leg straightened... start physical therapy Monday a little nervous the pain is going to be even more excruciating.

[@kevinmetcalfe9734]

After 4 months post op TNR I can only get 90% rotation is worth me carrying on trying to get more, I am 70 years old. Thank you

[@dr.samanthasmith]

Debatable. Are you able to do everything you want to? I would stretch 1-2x per day to help with stiffness and tight muscles. It’s possible to gain more motion even at 4 months

[@kevinmetcalfe9734]

@@dr.samanthasmith thanks

[@kimsimpson8205]

Do you have any tips for incision management? I know TKA is about function and relieving pain. But if there's anything you know that I can do to have the best looking scar possible would be great.

[@dr.samanthasmith]

Yes! Once the scar is completely healed (there has to be no scabs left- not even a single tiny dot) you can use silicone sheets or silicone gel. I have some linked in my Amazon store. www.amazon.com/shop/dr.samanthasmithptdpt/list/8N0BDML5EF6G?ref_=aip_sf_list_spv_ofs_mixed_d

[@kimsimpson8205]

@Dr. Samantha Smith oh fantastic thank you so much. Not quite there yet. Just 17 days post op.

[@kathystclair9485]

@@dr.samanthasmith I only have to use the silicone sheets when I wear jeans. Very helpful.

[@debbie6787]

I am 3 weeks PO and I take only Ibuprofen during the and most nights. I still suffer from severe muscles spasms, bad enough that they just lock up and you can visually see the line of the spawning muscle. When that happens I have to take a muscle relaxant, but those times are getting less and less frequent.

[@dr.samanthasmith]

Very good!! You are right on track