Pain control after Joint Replacement

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Pain control after Joint Replacement?
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• The biggest anxiety before taking Joint
  Replacement surgery with the majority of patients
  is post-surgery pain. How badly is this going to
  hurt?
• The bad news is that some pain is an inevitable
  companion to most types of surgery. The good news
  is that there are many highly effective
  medications to keep post-surgical pain under
  control. Surgical pain is an unpleasant sensation
  caused by the damage done to tissue by the
  incision, the procedure itself, the closing of
  the wound, and any force that is applied during
  the procedure.
• Pain control after surgery is a very real concern
  for many patients.  Some lucky patients are
  astonished at their lack of post-op joint pain,
  citing immediate relief (a true Christmas
  miracle!). On the other hand, some patients
  experience long, lingering pain after surgery.
  Even if you fall into the unlucky group, one
  thing is for certain you will eventually
  experience less hip or knee pain than before
  surgery and you will find your new normal. With
  some preparation, we are better equipped to deal
  with the discomfort, pain, and other associated
  hurdles after the procedure. Here are a few
  things to consider that may help through the
  process.

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There will still be pain after the procedure

• This is almost inevitable and its important to
  come to terms with this before moving 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. Everyones pain tolerance and the
  way in which they respond to painful stimuli are
  different. Having pain doesnt mean we are weak
  it just means were human. The role of the
  operating team is to help reduce your pain after
  surgery, but it most likely wont be eliminated.

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Opioids for post-op pain control

• 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. They are now prescribed
  for initial days in small quantities 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.

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Multimodal Approach (a cocktail of a variety of
options)

• There are various concepts of pain management
  protocols. Many surgeons now utilize combinations
  of medication and pain reduction techniques 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 physical therapy 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.

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Follow your exercises

• A physical therapist will recommend exercises to
  help strengthen muscles, increase range of
  motion, and increase blood flow around the knee.
  This promotes healing and helps drain fluid away
  from painful tissue

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Meditation

• It might not feasible to eliminate our 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. A good support system of friends and
  family members also can be helpful. The time
  after surgery is a good time to steer clear of
  people or things that cause you stress or
  anguish.
• There are many different types of treatments used
  in combination to control pain
• medicines
• physical therapy
• cold (ice packs)
• integrative therapies music, relaxation
  techniques, massage meditation
• nerve blocks

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• Taking pain one day at a time with the support
  and mentorship of others whove overcome this
  trying time can make the pain, well, less
  painful. 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, dont hesitate to
  discuss pain and pain management with your
  surgeon prior to surgery.  With these new
  multi-modal therapies using a cocktail of
  concepts, pain is way better controlled today.
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