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Prima Care

  • 277 Pleasant St, Suite 101, Fall River, MA 02721
P R I M A C A R E

How painful will joint replacement surgery be?

Jay Patel

Jay Patel

Recovery from joint replacement surgery can be a challenging process, and pain management is an essential aspect of the recovery process. Everyone will have some knee pain or hip pain after surgery. Usually either before or during surgery a nerve block is performed to help you with pain in the immediate 1-3 days after surgery. The nerve block helps numb the area to help control pain in the initial stages. Despite having a nerve block you will still experience some level of pain.

Based on each patient’s preexisting medical conditions, allergies, age, personal preferences, we offer patients a multi-modal approach (using different types of medications/methods to work together) to controlling inflammation/swelling and thereby controlling pain. I would be remiss if I did not thank Dr. Andrew Wickline (https://www.lessswellinglesspain.com/) for his extensive research into this aspect of joint replacement surgery. Since we adopted parts of his postoperative pain control protocol, we have seen a dramatic decrease in the use of narcotics and opiods after surgery (and patients have been pleasantly surprised at how little pain they have).

The goal of our post surgery pain protocol is to decrease inflammation/swelling which helps to decrease overall pain (and stiffness). It involves a combination of various medications that all work synergistically through different pathways.

  • Medications: Pain medication is often prescribed to manage pain after joint replacement surgery. Medications such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. Opioids, such as oxycodone and hydromorphone, may also be prescribed for severe pain. A few of the more common pain medications prescribed after joint replacement surgery are noted below:
    • Acetaminophen: Acetaminophen is a commonly prescribed pain medication after joint replacement surgery. It is an over-the-counter medication that is used to relieve mild to moderate pain. It works by reducing the production of prostaglandins, which are chemicals that cause pain and inflammation.
    • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as meloxicam/celebrex/naproxen/ibuprofen, are also commonly prescribed after joint replacement surgery. They work by reducing inflammation and pain. Some are available over-the-counter and others by prescription.
    • Opioids: Opioids, such as oxycodone, may also be prescribed after joint replacement surgery to control severe pain. They work by binding to specific receptors in the brain and spinal cord, blocking the sensation of pain. However, they also have a high potential for addiction, dependence, and overdose.
    • Steroids: dexamethasone is an oral steroid that can help reduce the swelling and inflammation in the body during the initial days after surgery. They should be used cautiously in patients with certain conditions such as diabetes, CHF, etc.
    • Topical medications: Topical medications, such as creams, gels, and patches, may also be prescribed after joint replacement surgery to control pain. They are applied directly to the skin over the affected joint and can provide localized pain relief.

  • CBD: Cannabidiol (CBD) is a compound found in hemp and other plants. CBD is not intoxicating or psychoactive unlike other derivatives from hemp, like THC. CBD is gaining popularity in treating pain. CBD can be an alternative to taking opioids with less side effects. Not all CBD products are the same and so you should discuss with your surgeon/medical doctor about the ingredients and side effects of any CBD product you may be considering or already using.

  • Physical therapy: Physical therapy plays a crucial role in the recovery process after joint replacement surgery. The therapy can help to improve range of motion, strength, and flexibility in the affected joint. Physical therapy can also help to reduce pain by promoting the release of natural pain-relieving chemicals in the body.

  • Cold and heat therapy: Cold and heat therapy can be used to manage pain after joint replacement surgery. Cold therapy can help to reduce swelling and numb the affected area, while heat therapy can help to increase blood flow and promote healing.

  • Transcutaneous Electrical Nerve Stimulation (TENS): TENS is a form of pain management that uses electrical impulses to stimulate nerve fibers and block pain signals. Manny physical therapy locations offer TENS after each therapy session.

It’s essential to note that everyone’s pain tolerance and management needs are different, and what works for one person may not work for another. It is important to work closely with your surgeon and healthcare team to develop a pain management plan that is tailored to your specific needs. It’s also important to follow all post-operative instructions provided by your surgeon and to communicate any pain or discomfort you may experience during your recovery.

With our combination of using muscle sparing approaches (direct anterior hip replacement and the Jiffy Knee), kinematic alignment strategies (for knee replacement) that doesn’t require the release of ligaments (unlike traditional mechanical alignment), ancillary pain control devices and a combination of different medications, most patients’ pain is controlled with little to no use of narcotics.