Intense pain after knee surgery peaks in the first few days, is managed with strong medication, and significantly lessens within 1 to 3 weeks, though discomfort can linger, becoming mild soreness for up to 3 months and potentially residual aches for up to a year as the body heals, with most patients seeing substantial improvement by 6 weeks and feeling more normal around 3 months, but ongoing severe pain warrants a doctor's check-up for infection or complications.
While some pain is expected after knee surgery, patients should contact their healthcare provider if they experience: Severe or worsening pain despite medication. Redness, warmth, or pus at the surgical site (signs of infection) Increased swelling or difficulty moving the knee.
After day 2 following a hip replacement, and day 4 following a knee replacement, you should be able to stop this strong pain relief or at least reduce the dose. We hope that 1-2 weeks after your operation, your pain will be much better and managed with simple pain relief like paracetamol.
Phase 1: The First Two Weeks – Acute Pain and Swelling
The first two weeks following knee replacement surgery are often the most difficult. During this phase, patients experience significant pain, swelling, and limited mobility as the body begins the initial stages of healing.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or celecoxib reduce swelling and control pain around the surgical site. You may also be recommended acetaminophen or other non-opioid medications as part of a multimodal pain plan.
Swelling of the knee and leg are normal after a total knee replacement. There are some things that you can do, however, to minimize this problem. Ice the knee frequently for the first two to three weeks after surgery. It is particularly helpful to ice after you have done your exercises or been on your feet for a while.
In general I would like you to be off the oxycodone in 5-14 days, and off of the tramadol in 14-21 days.
These medications reduce inflammation and relieve pain. Examples of NSAIDs include diclofenac, ibuprofen and naproxen. Two other anti-inflammatory painkillers with a similar effect are celecoxib and etoricoxib. These are COX-2 inhibitors (also known as coxibs).
It's important not to overextend yourself during the recovery process. If you experience persistent or increased knee pain, discomfort or swelling while doing any physical activity, it's best to ease off and seek medical advice. Walking is a relatively safe and accessible exercise during your recovery period.
Lifestyle and home remedies
Note: Side sleeping is usually an option several weeks into recovery, not immediately after surgery. Always check with your physical therapist or surgeon before trying this position.
Proper walking is the best way to help your knee recover. At first, you will walk with a walker or crutches. Your surgeon or therapist will tell you how much weight to put on your leg. Stand comfortably and erect with your weight evenly balanced on your walker or crutches.
The biggest cause for concern with worsening pain after knee replacement is infection. Typically, early after a knee replacement—within the first six weeks to three months—this presents with significant redness, swelling, and worsening pain that does not improve with ice, elevation, and rest.
You've recently had a knee replacement and you have:
Patients who undergo robotic knee replacement surgery are often able to leave the hospital within 1 to 4 days and are able to take care of themselves and resume most activities within 4 to 6 weeks after surgery.
Adjust your sleeping position
“If you sleep on your side, place a pillow between your knees to reduce pressure on your joints,” says Dr. Burns. “If you prefer to sleep on your back, try sliding a small pillow or rolled towel under the knees for support.”
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The #1 mistake making bad knees worse is excessive rest and a sedentary lifestyle, leading to weaker supporting muscles, stiffness, and a vicious cycle of more pain; instead, gentle, consistent movement (like walking, swimming) is crucial to strengthen the joint and improve function, though it must be balanced with avoiding activities that cause sharp pain. Other major errors include ignoring pain signals, carrying excess weight, wearing unsupportive shoes, and poor movement patterns, says Parkside Sports Physiotherapy and Coastal Empire Orthopedics.
How to relieve nighttime pain after knee replacement
Other studies have suggested that opioid use may negatively impact wound healing, by reducing immune activation, impacting tissue oxygenation and angiogenesis(15, 16) and altering myofibroblast recruitment as well as impacting keratinocyte cytokine production, endothelial proliferation and angiogenesis(15–17).
It's used to treat severe pain, for example after an operation or a serious injury, or pain from cancer. Sometimes it's also used for other types of long-term pain when other painkillers, such as paracetamol, ibuprofen and aspirin, have not worked.
To minimize the swelling in your leg, you need to elevate your operative leg above the level of your heart. This should be done at least three times per day for 30 minutes each time. Place your leg on the top of several pillows while you lie on your back.
Your body and your knee joint will continue to gain strength for several months after your surgery. There shouldn't be any pain after the first four months. If you continue to feel pain, be sure to talk to your surgeon.
Generally, heat is more effective at reducing stiffness and speeding recovery. Ice for knee pain or other joint paint is only recommended for severe pain, injury, and swelling, Ice for joint pain can help in cases like post-surgery recovery or for visibly swollen joints².