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Fatigue after Joint Replacement Surgery

Feeling tired after your orthopedic surgery? You’re not alone. Here are a few reasons why you may experience fatigue after surgery.

Feeling tired after joint replacement surgery? You’re not alone.

Having an orthopedic surgery can leave you feeling tired for weeks or months after the procedure. Here’s a list of 7 main causes of fatigue after surgery: surgical stress, blood loss, medications, pain after surgery, energy of healing, dietary changes, and sleep disturbance. 

Surgical stress

Undergoing even a minor procedure puts a big stress on your body. While anesthesia may prevent you from feeling and remembering the surgical procedure, it doesn’t change the stress response your body undergoes during surgery while you’re asleep. During periods of mental or physical stress, our bodies release hormones that help us cope with, and respond to, the stress appropriately. This aftermath of this stress response, however, can leave you feeling exhausted after the fact, just as you do after a stressful day at work or hard exercise session. It can take days or weeks for things to return to normal and your body to overcome the stress of surgery.

Blood loss

Any surgical procedure results in some blood loss. Depending on the surgery performed, blood loss can even be high enough to require blood transfusions. Regardless of the amount, loss of blood can result in fatigue after the procedure, as well as a generalized sense of weakness. It can take several weeks for the body to rebuild the blood supply back to normal after surgery.


Medications given to you before, during, and after your procedure can also cause fatigue after surgery. Anesthetic and sedative medications work by nervous system pathways that are responsible for sleepiness and muscle relaxation. While most of these medications completely wear off after a few hours, it can take several days for the pathways they affect to fully recover, resulting in lingering grogginess. Narcotic pain medications, nerve pain medications, and anti-nausea medications are also commonly given around surgery. The direct effects of these medications, as well as the negative effects they have on sleep quality, can cause tiredness and fatigue.

Pain after surgery

Postoperative pain is common after surgery and can cause fatigue through its effects on sleep and mood. Pain has negative effects on sleep quality, duration, and nighttime awakenings. Poor quality restless sleep results in increased daytime sleepiness and fatigue. Pain can also lead to depressed mood, which is associated with a general sense of tiredness.

Energy of healing

Recovering from surgery requires a significant amount of energy. Your body will be putting a large amount of effort into healing the surgical site. Using crutches, canes, or walkers may also increase the amount of energy it takes for you to get around after the surgery. Physical therapy and exercise after surgery may push your physical activity farther than it was before surgery. For all of these reasons, you may feel more tired than normal after surgery as your body is using energy for the healing process. 

Dietary changes

Changes in diet are common around surgery and can cause fatigue. The night before and day of surgery, you most likely didn’t have much to eat or drink. After surgery, nausea, vomiting, and pain can further decrease your appetite. Less food means less energy for your body to function normally and can cause weakness. Additionally, the mental stress of surgery can also cause you to reach for less healthy, high sugar or fatty “comfort” foods that may cause peaks and crashes in your energy levels.

Sleep disturbance

Poor sleep after surgery may lead to fatigue as well. Anesthesia can disrupt the normal flow and architecture of the stages of sleep for several days to a week after surgery. Pain can cause frequent nighttime awakenings. Pain medications like narcotics may cause drowsiness but lead to poorer overall quality of sleep. Depending on the surgical procedure, position, or movement restrictions may also force patients to sleep positions other than their normal preference.

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