Leg Pain

  1. Hi All,

    I am hoping someone could offer a solution to my husbands leg pain. A brief history, he had a total knee replacement in '99, since then he has had progressive pain in his knee down into his calf Sometimes it is shooting pain but mostly just a ache. His Dr. has done a venogram to r/o DVT , CT scan, Bone Scan, so far no infection, no DVT, placement is good. His pain is so bad that we never leave the house anymore. He takes ibuprofen 800mg and Darvocet for his pain, he does not abuse his medication, he usually only takes darvocet once a day at bedtime so he can sleep, lately this isn't helping either. Sometimes his leg is swollen, I bought him different socks , light support but that also doesn't help. I was wondering if any ortho nurses have experienced a patient with chronic pain like this and if so, what can be done. Now let me tell you he is overweight and is trying to lose weight and exercise. The exercise just irritates his leg more. He is only 49, too young to be stuck in the house, his job is sedentary so he doesn't have much walking to do.

    If anyone has any ideas I would greatly appreciate it.
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  2. 11 Comments

  3. by   sunnygirl272
    has his back been checked?
  4. by   BadBird
    Not specifically, but I think it would have shown up on one of his scans if he did. I think it is a nerve being compressed but that is just my guess. I iced it today and it did relieve some pain. Poor baby, I just wish I knew what to do.
  5. by   RNonsense
    What about a trail of Gabapentin/Neurontin?
  6. by   LasVegasRN
    Originally posted by sunnygirl272
    has his back been checked?
    That was going to be my question. The only other test that can be done to check for nerve impairment would be an EMG and/or NCS. It's possible that it could be originating from a spinal nerve - that can only be picked up on an MRI, but the nerve testing can help in the diagnosis.

    Other recommendation is to consult with a physiatrist or neurologist (I'd tend to go with the physiatrist because he/she can also do the nerve testing). At first, I thought it might be possible your hubby has a faint tibial plateau fracture, but the CT scan would have ruled that out and it wouldn't be there with the prosthesis.
  7. by   BadBird
    Against his protest, I made a appointment with our family Dr. We need to get referals to go to a specialist, so I will try to get one for nerve testing. Thanks for the suggestion.
  8. by   Glad2behere
    Sounds like a vascular problem to me if he is having attending edema, and has developed some scar tissue.
  9. by   DIPLOMATICRN4HIRE
    Did the pain start before or after the Total Knee?
    Have any of the flexions changed?
    Zoe
  10. by   BadBird
    The pain he had before surgery was different, he injured his knee at work, crushed his knee which is why he needed the replacement. He has decent flexion but I think it is vascular. He is such a PIA he won't listen, threw a fit when I told him I made a Dr. appointment. geeze, if I had pain I would want to get rid of it, what's with men? And of course just because I am a RN he thinks I have xray vision like I can look right through his knee and immediately know what the problem is !!! But does he listen to me, NO NO NO, If he doesn't keep this appointment I told him never to tell me he has pain again, I am tired of his complaining and not doing anything to get better, sounds mean but if you lived here you would understand.
  11. by   DIPLOMATICRN4HIRE
    Well thet can do a scan on it which isnt evasive at all. To be honest if it is vascular he will need a angiogram to see how vascularized the leg is itself its highly possible the vessels could have been damaged during the accident itself and possibly colateral circulation is possibly blocked at some point. Is it cool to touch or any area around the knee swollen with an area of hightend tenderness.
    Zoe
  12. by   semstr
    Is he moving his knee enough?
    Do you own a hometrainer (a bicycle in this case)?
    We always encourage the total-knee-patients to get one, so they can move the knee-joint without to much weight and strength.

    MIL had both her knees done, and even after 2 years, uses her bike when the pain starts and they get better when she is cycling.
    She has bad pains at the moment, but we all guess that they are due to the very cold weather at the moment.

    Good luck for your hubby, Renee
  13. by   Jay-Jay
    originally posted by badbird
    the pain he had before surgery was different, he injured his knee at work, crushed his knee which is why he needed the replacement. he has decent flexion but i think it is vascular. he is such a pia he won't listen, threw a fit when i told him i made a dr. appointment. geeze, if i had pain i would want to get rid of it, what's with men? and of course just because i am a rn he thinks i have xray vision like i can look right through his knee and immediately know what the problem is !!! but does he listen to me, no no no, if he doesn't keep this appointment i told him never to tell me he has pain again, i am tired of his complaining and not doing anything to get better, sounds mean but if you lived here you would understand.
    beeelieeeve me, bad bird, i understand! :d men...sheesh!

    my better half keeps asking me what to do about this, that and the other thing, then doesn't take my advice. then when i turn a deaf ear, he says, "you know i think i'd have to die to get your attention and sympathy!"

    right now he's in a cardiac rehab program, and he keeps telling me all this wonderful stuff, about how fat has twice the calories of sugar, and how he's at long last quitting ice cream, and how when you're exercising for cardiac benefit, you shouldn't stop to do training with the dog every 2 minutes.... there's times when i bite my tongue until it bleeds to keep from screaming: i've been telling you all this for years!! why the heck didn't you listen to me??

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