Setting Pain Goals after Orthopedic Surgery
Pain control is a key part of your care after surgery that can help speed recovery and improve the results of your surgery. This handout was written to help you understand how pain is managed after surgery. It describes:
- Setting realistic goals for pain control.
- How pain is managed.
Realistic Goals for Pain Control
It is very hard to safely do away with all of your pain. Pain medicine can make you very sleepy and may affect your breathing. We will work with you to keep you safe and help you be as comfortable as possible. To help make this happen, we will talk with you about what to expect and how to set realistic goals for pain control. Your nurses will always be working with you to find the best way to manage your pain.
People feel pain in many ways. Although it varies with each person, you should expect to have some degree of pain after surgery. It is not realistic to expect to have no pain. We will ask you to tell us about your pain using a scale of 0 to 10 where 0 = no pain and 10 = the worst pain you can imagine. These pain rating numbers are used along with other measures that include how well you can move, eat, and sleep.
Most patients can manage with a pain level in the mild (1-4) to moderate (5-7) range. If you have severe pain (8-10), your goal should be to reach a pain level in the 3-5 range. It needs to be low enough so you can walk, rest, and do any required activities. Good pain control should also allow you to get some rest without getting too sleepy.
Setting realistic pain goals after surgery may help you measure your progress as you get better. The nursing staff will help you to set a realistic pain goal and match it with your activity goals. For instance, your pain goal for the day may be 6, and your activity goal may be to sit up in the chair for all meals. At the end of the day, you should think about your progress and decide if your pain goal was realistic. You may need to change your goal.
How Pain is Managed after Orthopedic Surgery
There are a number of options your doctor may choose from to manage your pain. Your doctor may discuss these with you before surgery. Our goal is to manage and reduce your pain to a reasonable level. We also want to reduce any unpleasant side effects from pain medicine.
Pain medicine may be given through your IV during your surgery and in the recovery room. Once you arrive on the inpatient unit, you may get IV pain medicine or pain pills. Other options include an epidural (“epi-dur-al”) or a nerve block. It depends on the type of surgery you have. An epidural is numbing medicine given into a small catheter in your back near your spine. A nerve block is medicine given into your operative arm or leg. This can be a one-time shot or a continuous infusion. In most cases, the epidural will be turned off the morning after surgery. The nerve block infusion will be turned off two days after surgery.
Our goal is to have you take pain pills as soon as you can because pills provide longer lasting pain control. Pain pills start to work within an hour and last longer than IV pain medicine. Some people may receive two types of pain pills. One is a long-acting pill that you receive two times a day and lasts about 12 hours. The second type is a short-acting pill that you ask your nurse for when you need it. It lasts 3-4 hours. You should let your nurse know about your pain before it becomes severe.
There are other pain control options that can be used along with your pain medicine to help control your pain. These include:
- Cold or warm packs
- Deep breathing exercises
- Imagery, which is using your imagination to create mental pictures or situations to help reduce your pain
- Changing position in bed
- Distraction such as watching TV or reading a book
To help you, we offer 3 special TV channels:
1. The C.A.R.E. channel (number 10 on your TV), which provides a continuous relaxation environment.
2. The Healing Images channel (number 15 on your TV), which includes breathing, meditation and imagery exercises.
3. The Chuckle Channel (number 11 on your TV), which offers light-hearted distraction with comedy.
You may want to combine some of these methods to see what works best for you.
Please let us know if there are pain treatments that have been helpful to you in the past. There is no one best plan that works and it often takes a while to find what works best for you.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 04/19/2013
Copyright © 04/19/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6962
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