How Long Does Pain Last After Knee Replacement: What to Expect

In the United States alone, surgeons carry out more than 790,000 knee replacements each year. If you're about to get one yourself, you may be wondering, "how long does pain last after knee replacement?"

Pain right after knee surgery usually lasts for 2 to 3 weeks. In some patients, it may last for 3 months up to half a year. Sore bruises can also last for 1 to 2 weeks after the procedure.

How Long Does Pain Last After Knee Replacement?

You may experience general pain for two up to three weeks after a knee replacement. This is normal as your body heals the wound left by the surgery. In this case, the general pain you may feel is usually what doctors refer to as "superficial somatic pain."

What Is Superficial Somatic Pain Associated With Knee Surgery?

Over eight in 10 post-surgery patients experience acute pain. Acute means it lasts only for a short time. Still, as many as 75% of these patients say that they feel moderate, severe, or even extreme short-term pain.

Superficial somatic pain is one form of acute pain most common in knee surgery patients. In fact, this is the type of pain you experience whenever you injure yourself. Since knee surgery involves incisions, the wound it leaves often causes somatic pain.

General somatic pain after knee surgery usually goes away as the surgical site heals. By the time it completely recovers, you should no longer experience somatic pain. According to surgeons, most surgical wounds heal within six to eight weeks.

So long as you take good care of your surgical wound, then you should feel less to no pain at all by week six to eight.

How Long Does Stiffness Last After Knee Replacement?

Some degree of stiffness is normal after surgery since you can't move the injured knee right away. If you undergo proper rehabilitation, you should no longer have a stiff knee by the third month.

For starters, correct rehabilitative practices help prevent scar tissue buildup. The formation of scar tissues, in turn, are some of the top causes of joint stiffness. This is why it's super important to get your knee moving as soon as your doctor allows you.

This is also why your doctor will likely let you walk within the first 24 hours after surgery. You'd need to rely on an assistive device, though, such as a cane, crutches, or a knee brace. Your healthcare team will also only permit you to walk a few steps during this time.

Speaking of which, your doctor will likely have you stay in the hospital for one to three days after the surgery. Your physician may extend this based on how much physical therapy you need. Your progression and recovery will also dictate the time you need to remain in the hospital.

Either way, you can expect your physical rehabilitation to start as early as day 2 after the surgery. You will still need a knee brace and other assistive devices (like crutches or canes) to help you get up and move. You can also expect your knee to start healing while you're still in the hospital.

Your physical therapist will also likely ask you to extend your knee from day 2 onwards. You'd want to start achieving full knee extension as early as this point. This can help reduce the risks of chronic knee stiffness.

What Are the Odds of Chronic Stiffness After Knee Replacement?

As many as 4% to 35% of patients can develop chronic knee stiffness after ACL surgery. Known as knee arthrofibrosis, it's one of the most serious side-effects of knee surgery.

Arthrofibrosis, or stiff knee syndrome, occurs due to excessive scar tissue build-up. If this happens, the knee joint can shrink, tighten, and become stiff and painful. In more severe cases, this condition can have a massive impact on a knee's range of motion.

Arthrofibrosis can also cause the following symptoms aside from chronic knee stiffness.

Worsening Knee Pain

Arthrofibrosis stems from excessive collagen production. As a fibrotic joint disorder, it usually restricts the motion of joints and induces pain. Scientists say that improper rehabilitation after surgery is one of its primary causes.

With that said, if the pain becomes worse after your surgery, talk to your doctor right away. This can be an indication that your knee is developing arthrofibrosis. This is especially true if you also experience reduced flexibility in your knee.

Burning Sensation in and Around the Knee

Inflammation, or swelling, is a natural response of the body to any type of injury. According to scientists, this bodily response is crucial to preventing deadly infections. After all, swelling is a sign that your body is trying to heal wounds or injuries.

Now, keep in mind that knee replacement involves surgical incisions. These, on their own, are a type of injury, so it's normal for the body to respond by swelling up. Most types of inflammation, in turn, often result in a warm or hot "feeling."

So, it's normal to feel some hotness in and around your knee after the surgery. As the swelling goes down within two to three weeks, so should this unpleasant warm sensation.

However, if the burning feeling in your knee doesn't go away after three weeks, it's time to call the doc. Arthrofibrosis may be developing in your operated knee.

Chronic Inflammation

In the US alone, six in 10 people deal with some form of a chronic condition. Many of these take the form of long-lasting or ongoing inflammation. This means that their immune system is always active, or in some cases, even "hyperactive."

It's not a common culprit, but arthrofibrosis can still cause persistent swelling. However, the inflammation it causes is different from that of fluid formation in the knee. With arthrofibrosis, the swelling often arises from the tissue build-up itself.

The excessive scar tissue can irritate the other components of your knee. This irritation can then trigger the immune system to respond. The longer the offending tissues stay in your knee, the longer the swelling lasts.

So, if you still have inflammation two to three weeks after your knee surgery, call your doctor. Your physician can pinpoint what's causing the swelling, and from there, treat it.

You should never ignore chronic inflammation as scientists say it can accelerate aging. The swelling may be in your knee, but if you let it persist, its long-lasting effects can spread to your other organs.

For example, long-lasting inflammatory conditions can raise your risks of heart disease. Health experts also associate these with diabetes, bowel diseases, and even cancer. So, that's a good enough reason to call your doctor if you still have swelling three weeks after knee surgery.

Can Pain Still Occur Three Months After Knee Replacement?

Yes, knee surgery patients can also experience ongoing pain aside from chronic stiffness. Indeed, an estimated one in five total knee arthroplasty patients experiences chronic pain. The pain, in this case, doesn't go away even after three months following the surgery.

What's more, the degree or intensity of pain can even worsen many months after the procedure. 

What About Pain Six Months After Knee Replacement?

Chronic pain in total knee replacement patients can last from three to six months. This also when the pain severity plateaus, which means that it reaches its peak and doesn't worsen.

However, some patients still report feeling pain even six months after the procedure. In many of those who do, the chronic pain usually lasts between one and two years. However, some patients can experience pain that lasts for three years or even longer.

What Can Cause Sharp Pain After Knee Replacement?

When people feel "sharp" pain, they usually refer to a sudden, shooting kind of pain. The pain can also feel like stabbing, piercing, or cutting sensations. Either way, the highly unpleasant feeling can be quite intense and may also fade and reoccur.

Sharp pain can occur in patients who've had a knee replacement. Such cases often arise from surgical complications, such as infections.

An implant that becomes loose can also cause stabbing pains. The same goes if a misalignment of the operated knee occurs.

Infections of the Surgical Site

By 2030, experts estimate that there will be up to 3.48 million knee replacement surgeries in the US alone. They also say that a rise in knee replacement revisions will contribute to this growth. All in all, they project knee revisions to grow by 601% from 2005 to 2030.

Infections are some of the possible causes behind knee replacement revisions. Most infections occur within the surgical wound itself. However, harmful germs can also invade the area around the artificial knee implant.

Researchers say that infections can affect between 0.4% and 2% of primary knee surgeries. This goes up to 3.2% to 5.6% in patients who undergo knee replacement revisions.

In any case, an infected knee replacement can result in both swelling and sharp pain. If you experience these two together, make sure that you let your doctor know. Your surgeon can determine if your knee has developed an infection.

Implant Becomes Loose

The proper functioning of knee implants depends on secure fixation to the bone. Many surgeons use cement to affix the implant onto the knee bones. The cement provides a secure way to "lock" the device in place.

However, some patients may have a biologically-fixed knee implant. This means that the implant doesn't get cemented onto the bone. Instead, the device's surfaces are rough and porous, which, in turn, promotes new bone growth.

The new bone should then grow into the spaces between the implants. This secures the device into place, which is why there's no need for cement.

Unfortunately, both cemented, and biologically-fixed knee implants can still become loose. This often occurs over time, and not immediately, except in cases of accidents like falls. However, a patient's weight and choice of activities may promote gradual loosening.

In some cases, normal wear and tear can also cause an implant to degrade. In this case, the friction wears away the implant's surfaces, so tiny parts of it can form around the joint. If this happens, the body may think that the particles are invaders, so it will try to "digest" the "offenders."

In doing so, the body may also destroy part of the bond that affixes the implant to the bone. As a result, the device can become loose. This loosening can then cause the knee to wobble, resulting in stabbing, sharp pains.

Misalignment of the Operated Knee

Proper alignment of a knee implant is just as important as its fixation to the bone. For starters, a poorly-aligned implant can irritate or even "poke" the surrounding tissues. This, in turn, can cause stabbing, sharp pain.

An incorrectly-aligned implant can also result in more scar tissue to form. After all, it can "injure" the surrounding tissues, so new tissue has to rescue the damaged ones. As mentioned above, the more scar tissue that forms, the higher your risks of stiffness.

However, one of the worse things that misalignment can cause is implant failure. In this case, your knees can become even more unstable, and it may feel "wiggly" or "jiggly." If your knee buckles or gives way, the misaligned implant can cause even more injuries.

At the very least, you may feel intense sharp pains.

Is Pain Worse at Night After Knee Replacement?

Yes, it's possible for the pain to worsen at night following a knee replacement surgery. This can happen because you feel more "attuned" to your entire body. This can then give you a heightened awareness of your knee, as well as the pain that comes from it.

Also, keep in mind that the body usually heals itself at night while you sleep. Because of this, your surgical wounds may feel itchier and have more pronounced pain.

You may also feel a greater degree of pain at night as you try to find a comfy sleeping position. In doing so, you may move your injured knee in an awkward manner, which can then cause pain. Or, you may bump your knee against something, which can also cause discomfort.

All these can then make it hard for you to sleep at night. You're not alone, as half of knee replacement patients experience sleep disturbances.

Should I Use Muscle Relaxers After Knee Surgery?

Many surgeons use muscle relaxants on patients who undergo surgeries. They do so to restrict muscle movement while patients are unconscious. However, researchers now associate them with increased risks of lung complications.

As such, you may want to avoid over-the-counter muscle relaxants after your surgery. You should only use them if your doctor prescribes them.

What Helps Pain After Total Knee Replacement?

It's vital to note that pain is often inevitable right after knee replacement surgery. However, you should also know that the success rate of such procedures is 90% to 95%. Successful implant placement also lasts for over a decade.

With that said, there are many ways to manage and ease pain following knee replacement. Here is a general guideline, including a timeline, of what you can do to reduce knee surgery pain.

Adhere to Your Doctor's Medication Prescriptions

Immediately after your surgery, your doctor may give you pain medication. This can take the form of intravenous or oral pain relievers. If you have low pain tolerance, your healthcare team may give you a strong opiate or opioid.

Don't worry, though, as you will only need this for a day or two following the procedure. After this, your doctor will put you on much milder anti-pain medications.

What's important is to follow everything indicated in your prescriptions. Never take these medications for longer than what your doctor tells you. More importantly, don't stray from the recommended dosage.

Initial Swelling and Pain Management After Knee Replacement

Most patients have moderate to severe swelling for the first few days after knee surgery. Some patients may also experience this degree of inflammation for several weeks. However, this should ease down within the third to sixth month from the day of the procedure.

You can help your knee recover from the swelling faster with the use of ice therapy. Icing can help reduce inflammation, so long as done immediately after an injury. In the case of knee surgeries, you may have to extend the cold treatment for as long as you have swelling.

Aside from cold therapy, it's also best to elevate the leg wherein you've had knee surgery. This will help prevent too much blood from flowing to the surgical site. The reduced blood flow, in turn, can help reduce swelling.

Get Plenty of Rest and Limit Knee Movement

You need plenty of rest, which is what you're likely to do during the first 24 hours following your knee surgery. However, you can still take a few steps during the latter part of the first day. After all, you would still need to heed the "call of nature."

The most important thing here is to place as little force and weight on your operated knee. For this, your doctor will likely prescribe a knee brace, a cane, or crutches. After a few weeks, you may no longer need the cane or crutches, but your physician may still require you to use a brace.

Introduce Gradual Movement to Your Knees

Bracing can help shorten the time you need to get back to your feet unaided as it secures your knee. In this way, a post OP knee brace helps restrict your knee joint to protect it from flexing too much. As your recovery progresses, though, you can adjust the brace's level of restriction.

It's important to introduce gentle movements to your knee as soon as you can after your surgery. For starters, this helps prevent your knee from developing excessive scar tissue. So, by performing gentle knee exercises, you can keep knee stiffness at bay.

To help prevent re-injuring your knee, though, it's best to keep using your hinged knee brace. This way, you can give your knee more support and stability, preventing it from "buckling."

Use Heat After Ice

By the time your knee inflammation has gone down, you may already switch to heat therapy. For this, ask your doctor if you can start using self-heating knee pads. Your physician would likely tell you to use these for a few hours a day, aside from your post OP brace.

Follow Your Recommended Exercise Regimen

Your doctor and physical therapist will create a progressive exercise regimen for you. This means that you'll have specific activities to follow for each "phase" of your recovery.

For instance, you may try bending your knees 90 degrees a week after the surgery. Don't worry if you still can't; what's vital is that you attempt to and that you do it slowly. Within seven to 10 days, you should also be able to fully extend and straighten out your knee.

A month after your surgery, your doctor or PT may already allow you to take long walks. They may also likely recommend reducing your reliance on your crutches or cane. However, you should still avoid crouching or squatting at this point.

So long as you stick to your exercise plan, you should be able to do more of your usual daily activities within a month. Pain, stiffness, and discomfort should also have improved significantly at this point.

Don't Let Pain After Knee Replacement Get in Your Way

There you have it, all the answers to your question, "how long does pain last after knee replacement?" Again, general pain usually lasts for up to three weeks, but it can be up to six months or even longer in some. However, the right post-OP care can help reduce the risks of chronic knee surgery pain.

So, be sure to follow your doctor's directions! Supplementing your recovery with assistive devices, like knee braces, can also help.

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