PT TALK: "Why do my joints still hurt after surgery?"

Depending on the stages of healing, many factors can contribute to sensations of discomfort and stiffness post-surgically. During healing, there are commonly some undulations in progress--days that feel crummy and days that feel relatively good.  It's important to recognize that the overall trajectory is toward improvement in function. 

"I tell my patients that the joint has hardware and that the pain they are experiencing is from the muscles and bone. Muscles because the surgeon had to cut through muscles to perform the joint replacement and bone because the bone is healing from being cut into to put the hardware in the joint." says Dennis McCrea, DPT. "If it is due to other surgeries involving tendon or ligament repair then the joint pain is from the swelling in the area and the joint only has so much space so if the swelling is reduced by ice/elevation/compression and gentle movements then usually the soreness decreases."

Surgery can often "fix" a part that is damaged, but sometimes there are more contributing factors to our pain, which cannot be addressed with a surgery.  After surgery a lot of healing needs to occur, and sometimes things just aren't going to be the same as before we were injured.   The healing process includes strengthening muscles to provide protection to the area, shock absorb the joint and move the joint normally, and this can take a lot of hard work and time.  Depending on how long the patient had the problem, the muscles become deconditioned and atrophied before and after the surgery due to muscles shutting down due to pain, compensation and decreased activity level.  With spine surgeries involving disc or nerve tissue, it can be more common to hear that "I thought the surgery was going to fix it".  Besides the above reasons, tissues such as nerves are very slow to respond once the structure that is the reason for the irritation of the nerve is removed or repaired.   The nerve can still be "angry" for a long time and they have to heal from an invasive surgery.

"This is a big topic I tend to broach early on in the client's rehab process." says Brace Hayden, DPT. "Managing one's short and long-term expectations for "full recovery", less joint pain, and returning to a higher level of activity is important, as many PT clients don't get to have a very in-depth discussion with their surgeon about how their healing process should go."

In summary, it should be remembered that each person undergoing surgery has a unique prior history and their respective post-operative recovery has a lot of potential variables that contribute to the long-term healing process (ie. their immune function, their activity level, the duration of time they had persistent joint pain prior to the surgery). 

​After your orthopedic surgery, rehabilitate with the expert physical therapists at Alpine Physical Therapy. Our physical therapists work closely with area surgeons to maximize your treatments. We coordinate your PT with your surgeon and use post-operative protocols, or timelines to help you safely and timely progress through your PT rehabilitation program.