Pain after hip and knee replacement
Hip or knee replacement surgery involves removing a damaged joint and putting in a new, artificial one with plastic, metal, or ceramic parts. The surgery relieves pain from osteoarthritis, the most common type of arthritis, caused by wear and tear on a join, and typically can help you move better and return to a more active lifestyle.
Recovery is usually surprisingly quick after hip or knee replacement, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). You may be standing or even walking the day after surgery, using a walker or crutches. Physical therapy, which often begins the day after surgery, strengthens the muscles around the new joint and helps you regain motion in the joint.
As your body heals from surgery, and due to some muscle weakness from inactivity, you’ll experience some pain after joint replacement — but it usually ends in a few weeks or months, according to NIAMS. Until the pain resolves, there are several ways to relieve it.
Pain treatment without opioids
Hip or knee replacement surgery recovery without opioids, or with very small amounts for a limited time, involves multimodal therapies — a combination of one to three pain management methods such as non-steroidal anti-inflammatories, peripheral nerve blocks (injections of a local anesthetic near nerves causing pain), acetaminophen and gabapentin/pregabalin (non-addictive prescription drugs to treat nerve pain).
Even when opioids are prescribed for pain after surgery, the ASA recommends the lowest dosage, using the drug for a limited amount of time, and combining it with the other multimodal strategies.
The American Society of Anesthesiologists has issued strong support for aggressively reducing opioid use and promoting hip or knee surgery recovery without opioids.
“The opioid crisis is devastating and affects everyone, rich and poor,” said James D. Grant, MD, president of the ASA. “It’s got to stop, and reducing opioid use during recovery after surgery and providing the necessary treatment people need are a big part of the solution. Physician anesthesiologists are most equipped to understand the intricacy of post-surgical pain and alternative treatment options to best manage this pain rather than relying solely on opioids.”
December 19, 2017
Christopher Nystuen, MD, MBA