Pain control after surgery is a very real concern for many patients. In reality, most patients who are considering orthopedic surgery have already been in pain for quite some time. You may be worried about the pain you’ll experience after surgery because it’s unknown, whereas the pain caused by your injury or disease is something you are used to and something you have grown to understand. With some preparation, you will be better equipped to deal with the discomfort, pain, and other associated hurdles after your procedure. Here are a few things to consider that may help you through the process.
1. You will have pain after your procedure. This is almost inevitable and it’s important to come to terms with this before you move forward. The goal of orthopedic surgery is to reduce pain and improve function, but that pain reduction usually comes after a period of recovery and rehabilitation. Everyone’s pain tolerance and the way in which they respond to painful stimuli is different. Having pain doesn’t mean you are weak; it just means you’re human. Your medical team’s goal will be to help reduce your pain after surgery, but it most likely won’t be eliminated.
2. You need to understand your options. Ask your surgeon what his or her typical pain management protocol is. Many surgeons now utilize combinations of medication and pain reduction techniques. More and more physicians are using non-opioid medications either in addition to or to replace opioids after surgery. These medications might include pain relievers such as acetaminophen, non-steroidal anti-inflammatory medications (NSAIDs), or even medications that treat neuropathic (nerve) pain. Other useful pain management methods might include cryotherapy (icing the surgical area) and gentle massage of the muscles. However, it is typically recommended not to massage too close to scars or wounds before they are healed. When physiotherapy is used after surgery, one of its initial goals is pain reduction. Joints and muscles are designed to move, and avoiding stiffness can help with short-term and long-term pain.
3. Opioids for post-op pain control. The thought of taking opioid medications may be worrisome to you. In general, this awareness of the dangers of opioids is a good thing. These medications can be dangerous when not taken as prescribed or if they are relied upon for long-term pain control. They do have a high potential for addiction. For these reasons many surgeons are now prescribing them in small quantities for the initial days after surgery with the intention to wean off these and transition to non-opioid medications as soon as possible after surgery. Opioids have other troublesome side effects in some patients like nausea, vomiting, and itching. Also, you can’t drive if you have been taking opioids. They impair your reaction time and can easily make you a danger to yourself and others on the road.
4. What if I have been taking opioids even before having surgery? The effectiveness of the medications your surgeon prescribes will be lessened if your body is already accustomed to being on strong pain relievers. There’s not much that can be done to change that. Ideally, you should reduce or eliminate narcotics (under your doctor’s care) before surgery. Opioids may be appropriate for short-term pain control immediately after surgery.
5. Meditation and mindfulness. You might not be able to eliminate your pain by wishing it away, but there can be real benefits to having a calm environment, a clear mind, and taking some time to meditate before or after surgery. There are many free or inexpensive smartphone apps that can help guide you. No matter what you call this peaceful time, make sure you plan for some time to yourself to think, relax, and rest. A good support system of friends and family members also can be helpful. The time after surgery is a good time to steer clear from people or things that cause you stress or anguish.
In summary, pain is real. But remember, there are many ways to help you cope with a certain level of discomfort or pain after surgery. As with any concern, don’t hesitate discussing pain and pain management with your surgeon prior to surgery.
Written by Dr. Guillaume Dumont who received remuneration as a Zimmer Biomet consultant for writing this article.