Total Knee Replacements can be very painful during the first few weeks after surgery. This can lead to various problems.
Pain Can Slow Rehab Progress
Pain after a knee replacement is normal.
However, sometimes the increase in pain after surgery limits the progress of range of motion, strength, and function. Then this physical limitation can lead to more avoidance, more sensitization, and more pain.
It can quickly become a vicious cycle.
This is why it's important to focus on decreasing pain in the early phase of rehab.
However, many times the pain solution is pharmaceutical. While this can be effective in some cases if used for a very short time (<3 days), it is not a long-term solution. Or even a short-term solution. In fact, using drugs to manage pain is often what creates a long-term problem.
Opioid Epidemic
Another complication of post-op knee pain is our current opioid epidemic.
There is a rise in addictions, overdoses, side-effects, and chronic pain due to opioid abuse.
We don't need more drugs or better drugs.
We need better options to reduce pain.
Because it's clear that prescription drugs are not the answer.
Healthcare Cost
And then there's the global economical problem.
There's the increasing cost on our society because of opioids: "55 billion in health and social costs related to prescription opioid abuse each year".
Then there's the overall cost of pain on our society. One study estimated that the national cost of pain ranges from $560 to $635 billion.
Yes, those numbers started with a B. As in BILLIONS!
Finally, there's the fact that healthcare costs for medical procedures and surgeries continue to rise. Just take a look at the chart below to see how we compare with other countries.
A focus on preventative care, controlling lifestyle factors, and low-cost alternatives to pain relief can significantly reduce our healthcare costs.
Solutions
Like many things, the solution is often complex and multifaceted.
But one low-tech, low-cost solution is Dry Needling.
What is dry needling?
"Dry needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. [It] is a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue, and to diminish persistent peripheral nociceptive input, and reduce or restore impairments in body structure and function, leading to improved activity and participation."
Since adding Dry Needling to my practice I have seen remarkable outcomes. People recover quicker. Their pain diminishes even faster. And they need less visits.
Knee Replacement Dry Needling
In 2012 researchers performed an experiment to assess the effect of Dry Needling on pain reduction for total knee replacements.
They had a physical therapist dry needle trigger points on the patient prior to surgery, while they were under anesthesia. They also had 2 other groups in the study: dry needling to non-trigger points and a control group with no dry needling.
The results were stunning. One month after the surgery the trigger point dry needle group had significantly less pain compared to the other groups. They also reported less need for post-surgery analgesics (see opioid crisis above).
Another take home is the fact that the patients were under anesthesia. Which greatly reduces the chances of a placebo effect.
Summary
Dry Needling offers an easy method for reducing pain, improving movement, and progressing function.
Specifically, one session pre-total knee replacement surgery lead to a significant decrease in pain after the surgery.
While Dry Needling is very advantageous for the patient, we should also consider the global healthcare benefits of this powerful modality. Less cost, less prescription drugs, less side effects, less burden, and less pain.
Not a bad deal.