Pain Management After an Orthopaedic Procedure
Overview:
Post-operative pain is something all patients fear. However, there are a number of ways available to manage the pain. The blog discusses the various ways.
Every patient is apprehensive about the post-operative pain he/she will feel after a surgical procedure. This is natural. Maybe they can feel better knowing that thanks to the constant advancement in medical research, there are a number of ways to help them deal with the post-op pain.
It is important to understand that after surgery, patient may feel pain/discomfort in areas other than the surgical site. The throat may feel sore. Back, neck and shoulders may ache. Any kind of movement may cause increased pain around surgical site.
Patients can rest assured that their doctors and nurses will help them deal with the pain experienced after surgery. This is not to say that there will be no pain at all, but there are options to manage the pain and reduce it.
Medications of course are the most common method chosen to alleviate pain. They will help lessen the pain and thus allow the patient to get mobile sooner and recover faster. However, research is showing that when medications are complemented by other treatment modalities like psychological therapies (meditation) and mind-body techniques (acupuncture), the process of pain management is further enhanced.
Importance of Pain Management
Aside from making the patient comfortable after surgery, pain management has some important benefits.
- When the patient’s pain is within control, he is able to get mobile faster. Getting mobile is important as it will improve blood circulation and reduce the risk of clot formation.
- Another important aspect of pain management is that it improves the patient’s ability to do deep breathing exercises and allows the patient to cough with minimum discomfort. While these may seem inconsequential, the fact is that being able to breathe deeply and clear the chest is important to prevent lung infections.
Before surgery, make sure to tell your doctor if you are already on pain medications and also about any medication allergies you may have.
Also Read: Why does Bone Pain get worse at night?
Pain Control Methods
Opioids
- When the pain is severe, opioids are prescribed for short-term pain relief.
- Individual hospitals have their own policies regarding opioid use.
- Opioids can be administered orally, intravenously (IV) or intramuscularly (IM).
- Though opioids are very effective for pain relief, there is always the problem of addiction associated with them.
- Hence, it is very important to stick to the required dosage and stop as soon as the prescribed period is over.
- Opioids can be natural or synthetic. Natural opioids are got from plants; synthetic ones are laboratory made.
- Opioids are very similar to the endorphins our body produces. They work by attaching to the receptors on the nerve cells in the brain, spinal cord and other body parts. By doing so, they block the pain messages being sent to the brain.
- They are fast acting and allow the patient to get moving faster; night time use of opioids promotes sound sleep.
- As already mentioned, the biggest disadvantage of opioid use is the chance of addiction but other than this there are other disadvantages too:
- Their use can make a person drowsy and confused.
- They can cause breathing difficulties and nausea.
- Patients may also find it difficult to pass urine.
- Constipation and itching are the other side-effects encountered.
Non-Steroidal Anti-Inflammatory Drugs
- NSAIDs are used to handle moderate to mild pain.
- If the pain is severe, then NSAIDs may have to be used in conjunction with opioids.
- Aspirin, Ibuprofen, Diclofenac, etc. are some of the NSAIDs we commonly hear of.
- NSAIDs do not have the risk of addiction that opioids do. They work by preventing the action of the COX enzymes.
- NSAIDs too have side-effects – stomach pain, stomach irritation, ulcers, nausea and diarrhea/constipation are some of them.
- Avoiding taking NSAIDs on an empty stomach may help with the side-effects.
Local Anesthetics
- Local anesthetics anesthetize a small region of the body.
- They are given as one or more injections to the part where the procedure is going to be carried out.
- Some small procedures can be performed under local anesthesia and they can also be used for pain management after surgery.
- They block the pain signals that are carried to the brain by the nerves.
- While they do not have side-effects like NSAIDs and opioids, there is a risk of allergy. This however can be overcome by letting your doctor know your complete medical history.
Regional Anesthetics
- This class of anesthetics blocks sensation in an entire region (for e.g., entire lower part of the body).
- They are used during and after major surgeries so that the pain is completely absent.
- Both spinal and epidural anesthesia come under this category.
- While spinal anesthesia is administered as an injection directly to the spinal canal, epidural is administered in the space around the spine.
- The effects of spinal anesthesia will last only for a few hours after the procedure but epidural can be adjusted to continue for a day or two after surgery.
Also Read: 4 Questions to Ask Your Orthopedician
Ways to Supplement Pain Relief
Mind-body relaxation techniques, acupuncture and aromatherapy to name just a few are some of the techniques that can complement pain relief through medication.
- Mind-body relaxation uses the ability of the mind to control the manifestation of pain. Meditation, yoga, guided imagery, etc. all come under this category. Meditation and yoga both have been proven to aid pain relief when they are practiced on a regular basis.
- Acupuncture has many benefits, one among them being pain relief. In acupuncture, thin needles are placed at acupoints (which are located close to nerves). When stimulated by needles, the nerves send a message to the central nervous system. This causes endorphins release which prevents pain signals from reaching the brain and thus effectively controls pain.
- Aromatherapy uses aromatic substances like essential oils to improve psychological well-being. Rose, lemongrass, lavender and tea tree oils are the commonly used essential oils. While the evidence to support aromatherapy is insufficient, some patients may find the process calming and can also use it before surgery to deal with anxiety.
- Sep 11, 2023