Managing Pain after Orthopedic Surgery


While some postoperative pain is to be expected after orthopedic surgery, the intensity and duration of that pain is unique to each patient. At Hospital for Special Surgery (HSS), all patients are seen and monitored by an anesthesiologist and surgical team after surgery in order to gauge pain and customize comprehensive pain management care.

Even before the surgery begins, your anesthesiologist is looking for ways to minimize the severity of your postoperative pain. At HSS we usually use a “multimodal” pain relief approach, where a variety of pain-relieving techniques are used to provide comfort. This is why approximately 90% of HSS’ joint-replacement surgeries are done under regional anesthesia, a type of anesthesia that is associated with less pain after surgery. (Don’t worry; you typically receive sedation during the surgery as well!) Your anesthesiologist will review your case and medical history and after discussion with you will determine the best possible anesthetic approach prior to your surgery.

Regional anesthesia is just one method of pain management – often times, your anesthesiologists will combine peripheral nerve blocks (a type of regional anesthesia that numbs specific nerves and can provide long-lasting pain relief) 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.

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 the Acute Pain Service (APS). The APS is led by an anesthesiologist and is made up of nurses, physician assistants, and other providers who specialize in pain management. These providers are available 24/7 to patients admitted to HSS under APS care.

The goal of surgical pain relief isn’t to eliminate pain entirely in the days immediately following surgery. The Acute Pain Service practice is to coordinate with physical therapists and nursing staff to ensure that postoperative pain is controlled well enough to safely and effectively start rehabilitation and get you back in the game.


Dr. Philip J. Wagner, MD, is an anesthesiologist and the associate director of the Acute Pain Service for the Department of Anesthesiology.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.


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  1. I will be have complete shoulder surgery and they are telling me a tear in rota-tor cuff is possible

    How lone is recovery and pain to expect after surgery. I am a female in my late 70’s

    1. Hi Rose- Recovery time varies from patient to patient, and this question can be best answered by your physician.

    1. Local infiltration of the surgical site with a “cocktail” of medications (e.g. local anesthetics, anti-inflammatories, morphine) is used for post-operative pain relief by some of the joint replacement surgeons here at HSS. There is scientific literature both supporting and refuting the efficacy of this approach for pain relief after joint replacement. Having seen a variety of pain-relieving techniques, it is my opinion that these local-infiltration techniques are most effective when combined with other pain relieving techniques, such as nerve blocks and a pre/postoperative multimodal analgesic regimen. Although opinion varies, my experience is that local infiltration is more effective in hip replacement surgery than in knee replacement surgery. – Dr. Wagner

    1. Hi Louis- Recovery varies from patient to patient and would best be determined by your treating physician.