Understanding Pain
Diagnosis & Understanding
4. Neck Pain
1:55
6. Painful Diabetic Neuropathy
1:46
8. Foot Pain
1:50
9. Ankle and Foot Pain
1:46
10. Cancer Pain
1:34
Non-Surgical Treatment Options
2. Bracing
1:30
3. Acupuncture
2:13
4. Physical Therapy
1:35
5. Cognitive Behavioral Therapy
2:08
Minimally Invasive & Surgical Treatments
2. Regenerative Medicine
2:06
5. Caudal Epidural
1:33
10. Sacroiliac Joint Fusion
1:39
11. Kyphoplasty and Vertebroplasty
2:05
12. Basivertebral Nerve Ablation
1:36
13. MILD Procedure
2:04
14. Spinal Decompression Surgeries
1:41
15. Artificial Disc Replacement
1:52
Robert Moghim MD
Anchor Healthcare
Knee Replacements- Why so many with chronic pain?
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Knee Replacements: Why Do So Many Patients Still Have Chronic Pain?
Knee replacement surgery is meant to relieve pain and restore movement, but up to 30% of patients continue to have chronic pain after surgery.
One major reason is nerve irritation or damage. During surgery, small nerves around the knee may become stretched, compressed, or cut, leading to ongoing pain, numbness, or burning sensations. Scar tissue buildup can also trap nerves, making movement painful.
Another issue is implant-related problems. If the knee replacement doesn’t align properly, becomes loose, or doesn’t fit the patient’s anatomy well, it can lead to stiffness, swelling, and discomfort. Some patients may also experience inflammation or sensitivity to the implant materials.
Muscle imbalances or joint stiffness can also contribute to pain, especially if the surrounding muscles and ligaments are weak or tight after surgery. Pre-existing conditions, such as arthritis in the hip or back, can continue to cause pain that may feel like it's coming from the knee.
Certain factors increase the risk of chronic pain. Younger patients, women, and those with pre-existing nerve conditions or severe arthritis are more likely to experience persistent discomfort. Obesity, poor surgical outcomes, and lack of proper rehabilitation can also play a role.
If pain continues after surgery, options exist beyond medication. Nerve blocks, radiofrequency ablation (RFA), and regenerative medicine can help manage symptoms. For more severe cases, spinal cord stimulation (SCS), dorsal root ganglion (DRG) stimulation, or peripheral nerve stimulation (PNS) may provide long-term relief. These block pain signals before they reach the brain and are reversible and adjustable, making them safer alternatives to additional surgery.
Knee replacement can be life-changing, but it’s not a guaranteed fix for pain. If you’re considering surgery or struggling with pain after a knee replacement, exploring all treatment options and getting multiple opinions can help you find the best path to lasting relief.
FAQs
Are certain patients at a higher risk for chronic pain after knee replacement?
Yes, certain factors increase the risk of chronic pain after knee replacement. Younger patients, women, individuals with pre-existing nerve conditions or severe arthritis, as well as those who are obese or have poor surgical outcomes, are more prone to experiencing persistent discomfort.
Can nerve damage during knee replacement surgery cause chronic pain?
Yes, nerve damage can cause chronic pain. During surgery, small nerves around the knee may be stretched, compressed, or cut, leading to ongoing pain, numbness, or burning sensations. Scar tissue buildup can further exacerbate this issue.
How can implant-related problems contribute to chronic pain post-surgery?
Implant-related problems, such as improper alignment, loosening, or poor fit, can lead to stiffness, swelling, and discomfort after knee replacement surgery. Inflammation or sensitivity to implant materials can also contribute to persistent pain.
What treatment options are available for chronic pain after knee replacement surgery?
Beyond medication, options like nerve blocks, radiofrequency ablation (RFA), and regenerative medicine can help manage chronic pain after knee replacement. For severe cases, spinal cord stimulation (SCS), dorsal root ganglion (DRG) stimulation, or peripheral nerve stimulation (PNS) can provide long-term relief by blocking pain signals before they reach the brain.
Why do some patients experience chronic pain after knee replacement surgery?
Chronic pain after knee replacement surgery occurs in up to 30% of patients. This can result from nerve irritation or damage during surgery, improper alignment or fitting of the implant, muscle imbalances, or pre-existing conditions like arthritis. Scar tissue can also trap nerves, making movement painful.