After joint replacement you will need pain
medication to help with the pain from surgery. As a physiotherapist I see how important pain
management is to how well you will recover. Patients who told us they struggled with pain
management after surgery said they didn’t know how to get the answers to their questions.
This video was designed to answer some of the most common questions patients have about
pain management. Hi, my name is Dr. Martin van der Vyver and
I am an anaesthesiologist on the Acute Pain Service.
You will remember that before surgery a member of the anaesthesia team met with you to talk
about the type of anaesthetic you would have during surgery.
We also play an important role in terms of pain management while you are here in the
hospital. The goal of your health care team is to make sure you are as comfortable as
possible. Good pain control allows you to do your exercises and move around better,
which is critical to your recovery. The Acute Pain Service will also help to determine what
pain medication will work best for you when you leave the hospital. Hi, my name is Shirley
Musclow and I am a nurse practitioner on the Acute Pain Service. As a nurse practitioner
I have advanced training and I specialize in pain management. A member of the Acute
Pain Service will usually come to your hospital room on the first and second day after surgery
and ask you questions about your pain. This is so we can determine what would be best
for you. We will ask you to rate your pain using a pain rating scale from 0-10. The number
that you choose on the pain rating scale and how you describe the pain helps us to determine
if the pain medication is working or if it needs to be changed. Your nurse will also
regularly ask you about your pain and we encourage you to let any member of the health care team
know if your pain is not well managed. Every patient is different in how much pain
medication you may need and how long after surgery you may need it. Your pain medication
will work best if taken at least 30 minutes before activities or exercises. Pain is often
more noticeable in the evening and should be well managed to allow you to sleep. When you leave the hospital you will be given
a prescription for pain medication from your surgeon. Your surgeon will likely prescribe
several medications; these may include an opioid pain medication (such as Hydromorphone
or Oxycodone), acetaminophen (which is commonly known as Tylenol) and an anti-inflammatory.
These medications work together and can help make you more comfortable and able to do your
exercises. If you notice that your opioid pain medication
is running low and you feel you still need it, please plan ahead and phone your surgeons
office 3-4 days before you run out. If you have already had your first follow-up visit
with the surgeon then call your family doctor. These medications especially the opioid can
have adverse effects or undesired effects. Many people taking opioid pain medication
experience constipation. If you are having difficulty with your bowel movements you should
drink more fluids, eat foods high in fibre and slowly increase your activity. In order
to help with this you may receive a laxative while you are in hospital and if you continue
to experience constipation while you are at home you may need to continue with a laxative.
Speak with your pharmacist or family doctor about what would be best for you.
Another possible side effect or adverse effect of this medication is stomach upset. If your
stomach is upset, try taking the medication with food. If this does not help, ask your
pharmacist or family doctor to recommend something to settle your stomach or try taking a smaller
amount of pain medication, for example take one tablet instead of two. If these suggestions
don’t help with your stomach upset, please call your surgeon. Your pain medication may
need to be changed. If the pain medication makes you very sleepy,
confused or quite dizzy, stop taking the medication and call your surgeon for further advice.
If your medication makes you a little sleepy or a little dizzy, and your pain is manageable
you can try taking a smaller dose, for example one pill instead of two. We hear a lot of concerns from patients about
the risk of addiction when taking opioid pain medication. This risk is low. However, it
is important to wean off the opioid pain medication when you no longer need it to allow you to
do your exercises or move around the home easily. If you find it difficult for reasons
other than pain such as the effect on your mood or sleep, to wean off your medications
please contact your surgeon (if before your first follow-up visit) or your family doctor
(if after your follow up visit with the surgeon). Weaning off this medication is important because
if stopped suddenly you may experience withdrawal symptoms, which could feel like the flu such
as fever, stomach upset, sweating as well as symptoms such as increased pain, feeling
tense and anxious. Experiencing withdrawal is not a sign of addiction but instead means
that you are stopping the pain medication too suddenly. You will find a recommended
plan for weaning off your medication as well as a tracking sheet in the pamphlet Top 10
Questions about Pain Medication that you will be given when you leave the hospital. We have a few other helpful tips that can
help reduce your pain. Each day it is important to plan to exercise and be active but include
rest periods. Often activities such as standing to cook, sitting in one position for a long
time or walking too long such as grocery shopping can increase your swelling and pain. Although
walking is a good exercise, it should be increased gradually. The first time you go for a walk,
try 5 minutes, if that does not make your pain worse, the next day try 6 minutes and
continue to increase it gradually. Applying ice to your leg can help reduce general
pain and pain after exercise. It is important though to remove the ice or move it to a different
spot after 10 minutes. If it is helpful you can put it back on your leg after one hour.
After surgery it is very important to manage your swelling. The best way to do this is
to lie flat and raise your leg with your knee straight above the level of your heart. While
in this position you could apply ice as well as complete your ankle pumping and buttock
contractions. Ideally stay in this position for 20 minutes and repeat 2-3 times per day. Your health care team wants you to have the
best possible experience following surgery so if you have any questions about pain management
please ask the team. When you are at home, if you have trouble managing your pain or
adverse effects from the medication please review the pamphlet Top 10 Questions about
Pain Medication provided when you leave the hospital. If your questions are not answered
in this information then call your surgeon’s office between Monday and Friday 8:00-4:00.
If it is after hours, weekends or holidays please contact the Hospital Coordinator at
416-967-8551. In summary,
Pain management is key to good recovery Don’t be afraid to take your medication
Plan ahead: Take your medication 30 minutes before exercising
Remember to call your surgeon if you are running out of medications
Check the pamphlet Top 10 Questions about Pain Medication for helpful advice
Call your surgeon’s office if you still need help
When you are feeling better remember to slowly wean off the medication. It is helpful to
use a tracking sheet We are grateful to the patients who have given
us ideas and feedback to help make a difference for future patients like you.

6 thoughts on “Managing pain after hip or knee replacement”

  1. Interesting video, but sadly did not address the issues I had of not being able to take narcotic meds and anti inflammatory. For me, and I don t speak for all those that can t take those meds, my after surgery recovery has been one step from Hell.

  2. Just had kneecap replacement at wrightington hospital x. So very painful x. Three days post op today x. Was having a lot of sickness due to the meds x. Couldn't tolerate anything and trying to get on top of the pain was a real challenge cause you need to start moving it sooner rather than later x

  3. AESCULAP has a class action lawsuit for not disclosing a failed creami coating on the metal plate that attached to the Tibia

  4. It’s been almost 2 months since my total knee replacement and I’m still have severe pain, how long will this pain last? I want it to go away, I want to walk like before I had it done, I want to bend it like before, but mostly the pain to go away. Can you tell me how long I will be in pain? I’m suppose to have my other knee done but I’m scared cause with this one I stopped breathing and they had to put me on life support. Please help

  5. I had left hip replaced at 10:00am and they wanted me up and walking by 6:00pm. I was still in a lot of pain and doctor was in room and i cussed him out because i told him i was very sensitive to pain. Had to stay an extra day because they could not manage my pain.

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