The proper use of pain medication after knee replacement surgery or hip replacement surgery is a very important aspect of recovery. When your post-op pain is controlled, your pain and stress is minimized and your body’s energies will focus on healing. You will be able to perform physical therapy and home exercises with minimal discomfort. Inadequately managed pain can actually hinder recovery.
Pain Medications During Surgery and Before Discharge from Hospital
During and shortly after your knee replacement surgery or hip replacement surgery, you will likely receive pain medication intravenously. This same IV was probably used to also deliver hydration, sedatives and/or anesthesia before and during your surgery.
Opioid pain relievers, such as morphine, fentanyl, and oxycodone, are usually injected into your IV catheter at regular intervals. You may also be offered patient-controlled analgesia (PCA) — a system that allows you to give yourself a fixed dose of the medication by pushing a button (this system then does not allow additional dosing until sufficient time has elapsed).
In some knee or hip surgeries and hip surgeries, your anesthesia and pain medication may be administered via epidural or nerve block catheter.
Pain Medications after Discharge
Shortly after your knee replacement surgery or hip replacement surgery and after you are discharged to go home, your surgeon will probably prescribe oral pain relief medication for you to take for several weeks or months at home.
It is quite common for your doctor to instruct you to take an opioid pain reliever in combination with a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen. The opioids are pills that contain the same type of medication that your IV delivered while you were in the hospital. They work well to control pain but do have common side effects such as drowsiness, nausea and constipation. The NSAIDS (like Advil, Motrin and Aleve) work to reduce swelling and soreness.
Dependence on and/or Addiction to Pain Medications
Although prescription pain relief medication is important to pain management after a knee replacement surgery or hip replacement surgery, many doctors, patients and patients’ families are concerned with addiction to the opioids.
It is entirely possible for the human body to become accustomed and dependent on the presence of a medication. Physical dependence, however, is not addiction.
Addiction is an uncontrolled psychological craving for the drug, even in the absence of physical pain and need. Occasionally individuals who become physically accustomed to a pain medication may need to consult with their physician and wean themselves from the medication over a period of weeks to avoid withdrawal symptoms. This doesn’t happen very often, however and provided it is done gradually, there should be no difficulties and certainly no lasting effects akin to addiction. Thousands of people each year successfully cease taking their pain meds without incident.
In most cases, a knee replacement patient or hip replacement patient will begin naturally leaving longer gaps between doses because they aren’t experiencing pain at such a level to serve as a dosage reminder.
There are individuals, however, who do become addicted. The percentage is very small and is highly unlikely as long as you are taking your medication exactly as prescribed by your doctor. Long-term opioid therapy is associated with little risk for addiction when given to selected patients with chronic pain and no history of substance addiction or abuse (about 0.27% of study participants), according to a review published in The Cochrane Library by Meredith Noble, MS, ECRI Institute, Plymouth Meeting, Pennsylvania.
It is very important to talk with your doctor about pain management before your knee replacement surgery or hip replacement surgery. Ask any questions you have about pain medication, let him or her know your concerns (if any) about dependency, addiction or meds in general. A solid understanding of your doctor’s perspective on pain management and medications and an open line of communication will do wonders for your peace of mind during your post-operative recovery.