Can knee surgery cause RLS?

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Volleyball Jen
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Can knee surgery cause RLS?

Post by Volleyball Jen »

I am 11 weeks post op from ACL and Meniscus (right knee) surgery. I now have "restless legs" but not sure if I have RLS. I haven't had one full nights sleep since surgery. Because of the sleep deprivation I am very depressed and fatigued. I have never had sleep issues before my surgery. Nothing seems to help me get sleep or stay comfortable while I am asleep. Am I suffering from chronic insomnia or do I now have RLS? Any help is greatly appreciated. Thanks, JG

jumpyowl
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Hello, Jen:

Post by jumpyowl »

You have to do a bit experimentation. First of all what type of sensation do you have in the leg(s)? Only in the right leg? Do the sensation diminish when you move the affected limb? (this is important and highly characteristic of RLS). :?:

Also it is important what medications you are on since the surgery. I am sure they gave you some pain killers. What were they and when have you stopped taking them. Did your symptoms appeared when you stopped taking the meds? :?:

Age and sex please, privately if you want as we collect such data in our private survey (General Topics/ORP).

Many questions but need info to offer opinion. :oops:
Jumpy Owl

Heronak
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Post by Heronak »

Hey Jen,

I've always had difficulty sleeping for many weeks/months post knee surgeries (9), particularly ACL reconstructions. I also participate on a knee replacement forum and inability to sleep after surgery is a VERY common complaint. RLS post-surgery has also come up for a few folks but seems to go away.

You've had major surgery and your body is working overtime to heal. Certainly the balance has been upset and will take time to equalize again.

Answering the questions posed by JumpyOwl can help determine whether it's RLS, but if it's mainly the inability to find a comfortable position I'd guess it's the trauma of surgery. Have you talked with your surgeon about it? Hope you find relief,

Heron

Volleyball Jen
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Joined: Mon Jul 12, 2004 8:06 pm

Thanks and answers to Qs - long reply

Post by Volleyball Jen »

Hello and thank you both for your insights. I am a 34 year old caucasian female. I had ACL (patellar autograft) and meniscal repair (no removal) surgery in early May. This was my only sports injury in 28 years of various competitive activities. I injured myself playing volleyball and WOW has my life changed. So, you're right, my body AND mind is working overtime. This wasn't my only surgical procedure in my life, but it was the most "radical."

To answer Jumpyowl's questions: I was prescribed Vicadin twice, right after surgery and then again about 6 weeks after for pain from the constant swelling. I woke up less frequently on the Vicadin and noticed I could go right back to sleep. I am not currently on anything.

Also, since I wake up pretty much at 2:00 am each day, I'm pretty groggy and not too focused on the legs - I'm more frustrated at being awake. I do notice though that while I'm trying to fall back to sleep - I'm in and out of sleep after I've awaken - my legs are all over the place. I toss and turn a lot. This keeps me in-and-out for a few more hours.

Last night I slept in my daughter's bed by myself (we shipped our kids off to a friends so that NOTHING could disturb me). I used wax earplugs and I shut the door, so no cat. I had a quite and light fan on. I also tried an over-the-counter sleep aide called Simply Sleep by Tylenol. Unfortunately, that has the same drug as Benedryl, which makes me jittery instead of sleepy. I called my OS hoping he would prescribe Ambien (sp?) which I believe is what calms the nerves and keeps you asleep. No call back from him yet. UGH!

Anyway, its just my right leg that gets stiff and sore when bent when I'm on my side. But both legs are affected since they usually work together when positioning. The discomfort does diminish when I change position. I somehow manage to sleep from 10 - 2 am, so I don't know exactly what is waking me. You'd think I'd be stiff and uncomfortable within those first 4 hours and wake up, since 4 hours is a pretty long time. I'm tired of being tired. It's really taken it's toll on me. I guess I underestimated the surgery/recovery. I hope I answered your questions so you can give me your opinions.

Thanks again, JG

jumpyowl
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Thanks for replying promptly, Jen

Post by jumpyowl »

HeronAK will correct me if I am wrong since she knows much more about knee surgery. I just comment on your discomfort whether it is from a bona fide RLS or not.

Yes, antihistamines (Benadryl) and, by the way, antidepressants also, are very bad for paresthesia which is the main symptom of RLS. Any over the counter sleep medication is bad for that.

Vicodin is similar to hydrocodone, contains a codein derivative. And they seem to be effective for RLS, even if there is no pain.

So are sedatives, not only ambien (which is expensive), but temazepam, lorazepam and other tranqulizers. Klonopin is used much for RLS but it is long acting (morning drowsiness).

If you have pain, nothing can beat an effective pain medication for good sleep.

If you are tense then a sedative is better for sleep than a sleeping draught.


Although there are some sleep medications (very hard to get, unless you have narcolepsy or fibromyalgia) that increase stage IV sleep which some of us badly need.

I hope this helps some. :)
Jumpy Owl

Heronak
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Post by Heronak »

Jen,

This is from the 2004 RLS Foundation Medical Bulletin (http://www.rls.org/pdf/2004_medical_bulletin.pdf) It's worth reading the whole thing:

Features of RLS

A. Essential criteria: These primary features must be present for a diagnosis of RLS.
1. An urge to move the legs, usually accompanied or caused by uncomfortable or unpleasant sensations in the legs (Sometimes the urge to
move is present without the uncomfortable sensations and sometimes the arms or other body parts are involved in addition to the legs.)
2. The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.
3. The urge to move or unpleasant sensations are partially or totally
relieved by movement, such as walking or stretching, at least as long as the activity continues.
4. The urge to move or unpleasant sensations are worse in the evening
or night than during the day or only occur in the evening or night. (When the symptoms are very severe, the worsening at night may not be noticeable, but must have been previously present.)

B. Supportive clinical features of RLS:
Presence of these features may help resolve any diagnostic uncertainty.
1. Periodic limb movements (during wakefulness or sleep)
2. Family history of RLS
3. Response to dopaminergic therapy

C. Associated clinical features: These features may provide additional
information about the patient’s diagnosis:
1. Natural clinical course following certain identifiable patterns
2. Sleep disturbance
3. Normal medical evaluation/physical examination

I'm not convinced you've got RLS by what you're describing, but I'm only relating it to my experience with knee surgery - I could very well be wrong! Regardless, you're not sleeping, which means life sucks. I had great success with a low dose of lorazepam for a sleep aid.

On the knee related subject, do you sleep with a pillow between your knees? I've found that's the only comfortable position for me. I've also found that major surgery, such as yours, takes several months to recover from. Wishing you patience and a good, understanding doctor,

Heron

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