It is very normal to feel nervous about pain after surgery. People commonly have questions such as: Will I feel pain after surgery? How long does pain last after surgery? How should I manage postoperative pain? Learn about these topics and more below.
Surgery is a physical stress on the body, so you should expect to feel some pain after surgery. However, safe and effective pain management after surgery is a priority for our clinicians at HSS.
The most important pain management goal after surgery is to keep your pain manageable enough to participate in activities that will help your recovery, such as physical therapy and sleeping comfortably. Unless your surgeon instructs you to remain still after the procedure, it is important to start moving soon after surgery to regain functionality. Moving soon after surgery can even help prevent some complications, such as blood clots or pneumonia.
Remember that some pain after surgery means your body is healing. It is a natural part of the process.
Each person’s brain and body interprets pain differently. While we can’t predict exactly how your body will feel pain after surgery, there are a variety of sensations that are normal to experience. You may feel pain that is dull, throbbing, stabbing, cramping, worse at night, constant, or on-and-off.
Keep your pain management team updated on your pain levels after surgery. Throughout your surgical experience, we will partner with you on using a variety of pain management techniques to help manage your pain.
The length of pain after surgery varies from person to person, and greatly depends on the type of surgery you have.
For the first day or two after surgery, your pain may be reduced while the pain management techniques you received at the hospital are still in effect.
After these wear off, you may notice an initial increase in pain. This is normal, and there are different ways to manage the pain, including ice, relaxation techniques, distraction, and non-opioid pain relief medicines approved by your surgeon. Opioids may also be included as part of your treatment plan as needed.
Initial pain from surgery may last for several weeks, with some pain lingering in the soft tissues as you continue to heal and perform certain activities.
As you heal, stiffness or soreness may linger for several months.
Different types of surgeries have different recovery times, and all recovery times will vary from person to person. You can talk to your surgeon about what to expect for your situation.
At HSS, our surgical pain management care is directed by some of the most experienced orthopedic anesthesiologists in the world.
Our anesthesiologists use a variety of pain management methods classified as regional analgesia. Regional analgesic techniques are pain management techniques that only affect specific areas of the body. Targeting specific areas of the body helps reduce your risk and provides better pain management directly at the surgical site.
Before surgery, you will talk with your surgical team about your medical history and any of your questions or concerns. Your team will tailor pain management methods to your needs. If your medical team determines that you may require non-routine pain management care (for example, pre-existing chronic pain/opiate usage, medication intolerance/sensitivity, substance abuse, difficulty with pain control in the past), we have a specialized team available who will work with you and your surgeon to tailor a plan to your needs. Your pain management plan may include a preoperative pain consultation and an interdisciplinary pain management service.
During surgery, our team uses regional analgesic techniques to prevent pain at the surgical site. The effects of these techniques can sometimes reduce pain for a day or two after surgery. Approximately 90% of joint-replacement surgeries at HSS are done under regional anesthesia (a type of regional analgesia that numbs specific nerves and can provide long-lasting pain relief). Regional anesthesia paired with sedation means that you will get targeted, effective pain relief while also being asleep for the procedure.
After surgery, you will be given instructions on using multiple methods of pain relief as you heal. Regional anesthesia is just one method of pain management. Your anesthesiologist will often combine peripheral nerve blocks and patient-controlled analgesia (PCA) pumps during the initial recovery stage. A variety of specific medications are also used for pain control. Every effort is made to come up with a way of safely controlling your pain that limits potential side effects. Although opiate-based pain medications remain the single most effective treatment for moderate to severe postoperative surgical pain for most people, your postoperative pain control is designed to use these medications at the lowest effective dose for the shortest period of time.
If the type of surgery you are having includes admission to the hospital at least overnight, your pain treatment will most likely be monitored by nurses, physician assistants, and other providers who specialize in pain management as part of the perioperative pain service (POPS). These providers are available 24/7 to patients admitted to HSS under POPS care. Sometimes surgeons choose to care for your pain with their own pain management techniques outside of the care of POPS team.
Some pain management plans may also include alternative methods of pain relief such as a nerve-block catheter, acupuncture, or other non-traditional methods. If you are interested in finding out whether these options would work for you, ask your surgeon. The effectiveness of these methods depends on your individual situation, whether there is help available to you at home, and your type of surgery.
The best pain relief after surgery depends on your type of surgery, as well as how your body responds to pain and to different pain relief methods. However, generally the best way to manage pain after surgery is by using several methods of pain relief at the same time, called “multimodal analgesia.” By using several different pain relief methods at once, you will be reducing pain with several different methods at the same time, which has the greatest chance of more fully providing pain relief.
Different pain relief methods reduce pain in different ways:
Using multiple methods together often creates the best pain relief. However, be sure to talk to your doctor about which activities and which over-the-counter medicines are safe for you.
The pain medicines you will be prescribed depend on your surgery, your experience of pain after surgery, and any individual limitations you may have in what pain medicines you can take. It is common to be prescribed a short-acting course of opioids after surgery to take in combination with an over-the-counter medicine such as ibuprofen, naproxen, or acetaminophen.
However, be sure to talk to your doctor about which medicines are safe for you to take. For example, some people cannot take NSAIDs because it is too risky for them to take a medicine that reduces blood clotting. Or some people may be prescribed oxycodone/paracetamol (Percocet), which is an opioid (oxycodone) combined with acetaminophen (Tylenol), so you shouldn’t take more acetaminophen in addition to the Percocet. Some patients also decide that based on their personal history or preferences, they wish to avoid using opioids if possible.
Your schedule for taking opioids and/or over-the-counter medicines after surgery depends on what you are prescribed. Generally. at HSS, surgical patients are prescribed a short course of opioid medicines to be taken on a schedule as needed (generally every four hours or so, as needed – but be sure to look at the directions on your individual prescription). Over-the-counter medicines should also be taken on a schedule (such as every 4 to 6 hours, every 6 to 8 hours, or every 12 hours), depending on the medicine and the dose. Be sure to follow the directions and take medicine exactly as prescribed (as written on the bottle), and do not take more than the maximum daily dose allowed for over-the-counter medicines (follow the directions on the bottle). Be sure to talk to your doctor if you have any questions. Dosing may also differ for children who are under a typical adult weight (approximately 95 pounds).
The length of time that you will need to take pain relief medicine after surgery depends on your surgery and your individual experience of pain. At HSS, most surgical patients are prescribed a short course of opioids after surgery. If you are about to run out of opioids and your pain is still not well-managed, reach out to your medical care team.
After major surgeries, pain and stiffness may last for several weeks or months after you stop taking opioid medicines. This is normal, and pain should continue to improve over time as you heal.
At HSS, not only do we have the best orthopedic surgeons in the United States – we also have the most experienced anesthesiologists and pain management doctors to help ensure that pain doesn’t prevent you from reaching your functional goals after surgery. We use the most advanced techniques to ensure your safety and help manage your pain before, during and after surgery.
If you have any questions about pain management, please do not hesitate to reach out to your medical care team.