Why Am I Still Having Pain 1 Year After Knee Replacement?

Causes of Pain 1 Year After Knee Replacement

When patients still have pain six months or a year following surgery, they worry something went wrong. The good news is, in most cases, everything is fine. However, persistent pain can still occur, and it's essential to understand why.

Research^{1, 2, 3} has identified five main predictors of chronic pain following knee replacement:

1. catastrophizing
2. poor mental health
3. high preoperative pain
4. pain at other sites
5. number of comorbidities

Vikki Wylde et al, 2018

Catastrophizing: The #1 Predictor of Persistent Pain 1 Year After Knee Replacement

Catastrophizing is thinking the worst will happen, and often, it's a self-fulfilling prophecy. Multiple research studies have identified catastrophizing as the biggest predictor of persistent pain after knee replacement.

Therefore, if you're going into a knee replacement, make sure you're confident that you need at and that it's the right decision. If you're not certain, wait until you are.

If you've already had a knee replacement and you're still having pain 1 year later, keep a positive outlook that you can still yet improve.

The Role of Mental Health on Chronic Pain

Poor mental health, including anxiety and depression, has been shown to be a predictor of persistent knee pain. Anxiety and depression can lead to poorer outcomes and greater dissatisfaction with many different medical conditions and procedures, including total knee replacement.

High Pre-Operative Pain Levels

You'd think that if you have a lot of knee pain that it would make you a good candidate for a total knee replacement.

However, the opposite is true.  The more pain you have before a knee replacement, the more likely you are to experience persistent pain after knee replacement.

This can be due to the sensitivity of the nervous system, where the nervous system remains irritable even after surgery.

Pain in Other Areas

People with widespread pain or pain in other areas, such as both knees or multiple joints, tend to experience more chronic pain.

This indicates a more central cause of pain, where the spinal cord and brain become over-responsive to painful stimuli (called nociplastic pain).

Comorbidities

Comorbidities like diabetes, obesity, and high blood pressure, especially when combined, can increase the likelihood of poor outcomes.

Improving overall health can help reduce chronic pain.

Practical Tips to Improve Knee Pain 1 Year After Knee Replacement

Pain is a biopsychosocial experience.

Vikki Wylde et al, 2018

Therefore, improving knee pain 1 year after knee replacement involves addressing both physical, mental, and social factors.

factors. Here are some practical tips:

• Maintain a positive mental outlook and avoid catastrophizing.
• Focus on overall health through a healthy diet, adequate sleep, and regular aerobic exercise.
• Manage stress and improve your mental health by seeking support from family, friends, or professionals.
• Perform exercises to relieve stiffness around the knee and improve range of motion.
• Set realistic expectations for recovery and focus on achieving a better quality of life.