Managing Pain After Joint Replacement Surgery

One of the top questions before joint replacement surgery is, "what pain can I expect?". Another top question is: How long will pain last after my total joint replacement? Despite knowing that everyone's pain is different, it is single-handedly (and understandably) the top thing people want to hear about. After all, nobody likes the idea of pain and certainly no one likes the idea of "unknown pain". Before we get into how to manage your post-op pain, let's break-down what pain you can expect after surgery. After all, the fewer surprises, the better!

Read the full article, "What Pain Can I Expect After Surgery?". The article shares the milestones of recovery you can aim to hit, levels of pain to expect, and more.

What Pain Can I Expect After Joint Replacement Surgery?

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So, how long DOES pain last after a replacement? First of all, it's important to know that each and every person will experience different levels of pain after surgery. Some lucky patients are astonished at their lack of post-op joint pain, citing immediate relief (a true Christmas miracle!). On the other hand, some patients experience long, lingering pain after surgery. Even if you fall into the "unlucky" group, one thing is for certain: you will eventually experience less hip or knee pain than before surgery and you will find your "new normal".

As a general rule of thumb, you should experience less pain the further you are into your recovery. In other words, the more time between you and your surgery day, the less pain you should feel. There are exceptions to this rule—especially for knee replacement recipients. As you increase your activity levels and decrease your dose of pain medication, you may notice a spike in pain levels (this is usually around the 2-3 week mark).

After surgery, pain is no longer "achy and arthritic". Post-op pain felt by patients is from the trauma of surgery, wound healing, swelling and inflammation.

When Will Pain After Surgery Stop?

Have we mentioned that everyone is different? Yes, we have. But really, everyone's pain levels and their recovery timeline is unique to them. In saying this, there are certain rough timelines and pain milestones that orthopedic surgeons report as patterns. Here's a rough outline for the various stages of your hip and knee replacement pain.

Timeline Hip Replacement Knee Replacement
In the Hospital Moderate pain from the trauma of surgery. Oral and IV pain medications keeping pain controlled. Moderate pain from the trauma of surgery. Oral and IV pain medications keeping pain controlled.
First 2 Weeks After Surgery Prescription narcotic pain medication taken regularly to alleviate pain. Pain will be moderate. Prescription narcotic pain medication taken regularly to alleviate pain. Pain will be moderate. May feel thigh pain on surgical leg.
2-8 Weeks After Surgery Narcotic pain medication doses typically lowered around 2 weeks. A noticeable drop in pain typically happens. Mild discomfort. Around the 6 week mark, patients report hip pain as less than before surgery. Narcotic pain medication doses typically lowered around 2 weeks. Pain can spike as pain medication doses lower. Physical therapy intensifies and mobility increases, causing heightened pain levels.
2-6 Months After Surgery Pain drastically lowered. Walking and moving around normally. Experiencing noticeably less pain Majority of knee replacement patients report “little pain” around the 3 month mark.
6+ Months After Surgery Increased joint movement and pain-free (or close to). Increased joint movement with significantly less pain.

Talk to your Doctor if it's been 3 months and...

  • You've gone through rehab therapy and pain is getting worse.

  • Your pain has never gone away, steadily causing you noticeable discomfort.

  • Your pain has gone away (or is quite low) and then suddenly comes back.

6 Ways to Manage Pain After Hip or Knee Replacement Surgery

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1. Take Your Pain Medication Like Clockwork

A lot of people are afraid of prescription pain medication (and rightfully so). Everyone has heard horror stories about addiction and the "opioid epidemic". However, when used responsibly for a short period of time, pain medication can be of great assistance in your recovery. After all, pain medications are created to...you guessed it...treat physical pain!

When taking your prescribed narcotics, make sure that you know exactly what you're taking and when you should be taking them. Be sure that your physician knows of any other medications that you're on that could interfere with the prescribed narcotics. Do not take more than prescribed dose. In a similar vein, do not take a lower dose than your doctor has recommended before speaking with your care team.

It's important to take your pain medication like clockwork in the days and first week (or two) that follow surgery. If you lower your dose without your physician signing-off, you may notice spikes of pain at night, have trouble sleeping, and actually roadblock your own ability to complete the necessary steps in your recovery. If you're experiencing too much pain, you won't sleep well, you won't perform the required exercises, and you will take-away from your own recovery.

Read more about safely taking narcotics to manage joint pain (before and after surgery).

2. Ice and Elevate

Icing and elevating after knee or hip replacement surgery will be your new best friend (or "BFF" as the kids are saying). Your care team will probably recommend that you ice up to four times a day, for 15-20 minutes at a time. Icing multiple times a day cuts down on inflammation and swelling, which in turn, will cut down on pain. Always pair icing with elevation. In other words, elevate while you ice!

Joint recoverees swear by the elevated foam wedges for elevating while icing and sleeping. Foam wedges are more transportable and less clunky than stacking pillows and blankets. Amazon sells foam wedges for $42 (hot tip: order before your surgery date!).

Renting or purchasing an ice machine is also something that patients rave about in our joint replacement support group. Ice therapy machines (also called cold therapy machines) circulate cold water and air through a cuff that you strap onto your affected joint. They can be left on longer than an ice pack (two hours or more). Some people also leave them on throughout the night and claim they played a big role in their recovery. Before sleeping with an ice machine, ask your doctor if this is a good idea.

Read more about the best icing practices after hip or knee replacement surgery. There's an ice-bucket-load of tips on how to get the most out of your post-surgery icing.

3. Keep-Up with Exercises and Physical Therapy

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Although your physical therapy sessions and at-home exercises may hurt while you're doing them (e.g. heel slides for knee replacement recipients), they'll pay off hugely in the long run. It's important to fight through a bit of short-term pain for long-term gain (however, do not push through pain that exceeds "uncomfortable" or "slight pain").

As you work through your exercises, you're combating stiffness, inflammation, swelling, and regaining movement and motion. It's absolutely integral to work your new joint right out of the gate. Those that do not work through the discomfort in their physical therapy sessions and perform at-home exercises will be worse off later in their recovery. Not exercising the joint (especially knee replacement knees) can lead to prolonged stiffness, worse inflammation, poor range of motion, and lifelong pain when bending or performing everyday movements.

4. Get Tissue Massages

A little further into recovery, some patients swear by tissue massage. Although it may be a little painful during the massage, the relief felt after can be great. Some patients even claim that they experience greater relief from massage than pain medication (crazy, eh?)!

Depending on your insurance, massage therapy may be fully or partially covered after orthopedic surgery. Alternatives to a professional massage can be working your surgical leg (thigh, calf and surrounding muscles) with a massage wand or with your own hands. Tissue massage can be extra helpful for those who are experiencing a lot of thigh pain or muscle pain surrounding their operated joint (this is often the case in knee replacement patients).

5. Try Pain Management Alternatives

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Meditation to manage pain may seem a little hokey, but for may patients, it really works. We've talked to countless patients who said they were reluctant to perform guided mindfulness meditations but found themselves recalling these lessons in the hospital to calm down and reduce pain. Practicing mindfulness is also very helpful at many points throughout recovery.

Mindfulness is a tool that helps people overcome the struggles caused by pain. Practicing mindfulness (also called "restful alertness") means being present in the moment. "Training your mind to stay in the moment and not wander to anxiety and fear-driven thoughts, keeps anxiety and stress at bay". Studies have found that practicing mindfulness to combat pain actually increases your pain tolerance.

Here are some of our best guided mindfulness meditation videos that aim to help you deal better with post-op hip and knee pain:

Mindful Breathing to Unlock Your Body's Healing Potential

Guided Free Diver Breathing to Manage Pain

Putting Pain Into Perspective

Making Friends With Pain

6. Know That You're Normal!

Although this last one is a little less tangible, a lot of patients report that knowing they're not alone in their pain helps them manage pain and stress. In other words, knowing that the pain you're going through is normal and is something that hundreds of thousands of joint replacement recipients have experienced, can help you make it through. Taking pain one day at a time with the support and mentorship of others who've overcome this trying time can make the pain, well, less painful.

Join our supportive group of people preparing for hip and knee replacement surgery and those in recovery. We'd love to have you!


Are you preparing or recovering from a joint replacement? If so, sign-up for PeerWell for better pain management and extra support.

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Hi, I'm Grace. I write and research about hip and knee replacements, PreHab before orthopedic surgery & ReHab. Content advised or co-authored with physicians (MD) and orthopedic surgeons (OS).

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