4 weeks post op tkr. still have 4/10 pain at night that keeps me awake. i hesitate to take more narcotics but i really need to sleep. any ideas?

See below:: You can still take the narcotics, if your orthopod advises, but continue to gradually wean yourself off them over a 2-3 weeks time. Tramadol is a good alternative, and some sleeping med for a 8-10 days might help. Doing regular exercises and pt will help to strengthen your muscles and decrease the pain as the knee gets stronger. Continue using a walker is helpful also, for maybe another 3-4 weeks.

Observation for now: It is not uncommon to have pain a month after a tkr. Common reasons are the therapy leading to swelling and inflammation of surrounding tissues. Rarely an infection can present this way and if a concern blood work or aspiration is needed. Recommend observation at this time unless pain becomes worse.