Medically Reviewed by Rodney K. Alan, MD

Three things to know about pain management following a knee or hip joint replacement: One, you WILL feel better after your total knee replacement  or hip joint replacement when you are fully recovered. Two, your medical team will use advancements in postoperative pain management to control your pain while you are in the hospital. And three, you should expect some discomfort when you return home.

“Generally, knee replacements have a bit more pain than those who receive a new hip,” says McLeod Orthopedic Surgeon Dr. Rodney Alan. “We work with patients to ensure that they have pain management tools that help you get a good night’s sleep, faster rehabilitation and full recovery once you return home.”

PAIN MANAGEMENT GUIDELINES & TIPS

• Try to stay ahead of the pain. Waiting too long to take pain medications may interfere with recovery. If your pain is severe enough to disrupt eating, sleeping, or physical therapy, talk with your doctor to see if any changes are necessary.
• Do not wait until the pain is at its worst. As soon as your level of pain is severe enough to make you uncomfortable while resting, begin your medication. This way the medication will already be working by the time the pain increases. If you wait and “try to catch up” to the pain, you may experience a cycle of uncontrolled pain, followed by excessive sleepiness once you finally take your medication.
• Report any severe side effects to your Orthopedic Specialist.
• Stay focused on your goals: elimination of pain and your return to a normal lifestyle.

Here are 3 major medication categories that you may use to control your pain.

OPIOIDS
Opioids control pain by attaching themselves to pain receptors and blocking the pain messages to your brain.
Advantages

• They control moderate-to-severe pain.
• They do not affect the lining of the stomach like NSAIDs and do not affect bleeding.

Disadvantages

• Although rare, extended use of opioids can lead to addiction. Follow your Orthopedic Specialist’s directions on their use. And stop taking these medications as soon as your pain improves.
• Side effects include itching, nausea, or constipation. Your medical team may suggest use of a stool softener if they send you home with an opioid prescription.
• The side effects can hinder your rehabilitation.

ACETAMINOPHEN
Acetaminophen (such as Tylenol) raises your body’s pain threshold. It can also be used to lower your temperature.
Advantages

• They can be combined with an opioid to control moderate to severe pain, while reducing the amount of narcotic medications you need.

Disadvantages

• They are not as effective at relieving severe pain when compared to opioids.

NON-ASTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)

This group of medications helps inhibit pain and inflammation by blocking production of the body’s enzyme (prostaglandin) that cause pain and swelling. Two commonly used NSAIDs are ibuprofen and Celebrex.
Advantages

• Unlike opioids, NSAIDs are not habit forming.
• Short-term use of NSAID ibuprofen does not cause nausea.
• COX-2 inhibitors found in Celebrex do not inhibit bone healing.

Disadvantages

• Prolonged or excessive use of some NSAIDs may damage the lining of the stomach in elderly patients or patients with a history of reflux or ulcers.
• They do not relieve moderate-to-severe postoperative pain as well as opioids.

Find an Orthopedic Specialist near you.

Sources include:  McLeod Health, National Institutes of Health, American Academy of Orthopaedic Surgeons, BoneSmart.com, Anesthesiology, Journal of Bone & Joint Surgery