Pain Management after Surgery When You Have Chronic Pain
This handout will help you work with your health care team to manage pain from surgery. It describes:
- What you can do to work with your doctors and nurses to get the best pain control.
- Types of pain treatment to use after surgery when you already have chronic pain and your body may be used to (tolerant of) pain medicines.
- A pain control plan.
Acute pain is a normal part of the healing process. Surgery may also for a short time increase your chronic pain. Research shows that pain can affect your emotions and behavior. It can also interfere with your ability to manage stress. Stress and emotions can make pain worse and impact your recovery. Pain management is an important part of your care. Knowing what to expect and having a plan to treat pain can help you recover more quickly.
Pain is complex and unique to each person. How does pain affect the way you think and act? What pain control methods work best for you? Good pain management involves communication, planning, and using a mix of medicine and non-medicine strategies. When persons are already on opioid (narcotic) medicines, nerve blocks and special methods may also be needed to control pain. Keep in mind, no one form of pain treatment alone is enough for either pain from surgery or for chronic pain. Mixing different types of pain medicine with non-medicine strategies is most effective. These strategies include things like relaxation, distraction, ice, and movement. Knowing what to expect and planning in advance can make a big difference.
What You Can Do
- Ask questions about your pain control options and make a plan with your doctors.
- Tell us what worked for you in the past. Try not to let past frustrations stand in your way.
- Share any fears you may be having. Tell us what you expect. Fear can increase your pain so it is important to be able to talk to your team about any worries you have.
- Discuss realistic goals for pain control. These goals should include control of your pain so that you can take part in your recovery. It should also include fewer pain medicine side effects.
- Plan to use a mix of medicine and non-medicine strategies.
- Think about bringing in your favorite music, book, or other form of distraction.
- Ask about options for use of nerve blocks and catheters to receive local anesthetics.
- Ask about what pain medicine to use before surgery.
- Discuss what you should do the morning of surgery.
- Review your pain control plan with your nurses and doctors. Talk with them about any changes that may be needed.
- Only you know the extent of your pain and how it affects you. Don’t be afraid to speak up.
- Accept support from family and friends.
- Although moving around increases pain from surgery, it is important for your recovery. It will help reduce a chronic pain flare.
- For most people you will keep taking the same dose of chronic pain medicine that you took before surgery.
- A different short-acting opioid or dose will be added as needed for the acute pain.
- Acetaminophen (Tylenol®) will often be given three to four times a day unless there is a reason not to.
- A nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen or celecoxib may also be given if your body can tolerate it, and it is ok for your type of surgery.
- Use non-medicine strategies such as ice, relaxation breathing, music, and distraction.
- You may also receive other pain medicines that your doctor decides will be helpful for you.
- Remember, no amount of medicine can completely get rid of pain. Understand what are realistic goals.
- Remember, using non-medicine strategies is as important and helpful as medicines.
The right medicine and the right amount are more important than the way it is taken.
Intravenous (IV) “shots” are not more effective in pain relief than many other methods. Although there are a variety of ways to take pain medicine, it is the pill form (“by the mouth”) which is actually the best method for most pain. Discuss with your doctor or nurse which method makes the most sense for you.
Planning for Home
- Discuss the plan to reduce your postoperative pain medicines after you go home.
- Within the first few days after surgery, you will need less frequent doses of the extra short-acting opioid for acute pain. Although you may go home with a prescription that allows you to take a dose as often as every 3 hours, you will be expected to slowly reduce this and plan to stop it within the first couple weeks. If more medicine is needed you will need to work with your primary care doctor or chronic pain clinic.
- Decide if you need to schedule an appointment with the doctor who prescribes pain medicine for your chronic pain.
- Ask the doctor or nurse what to expect.
- Admit your feelings about pain and how it affects you. Share this with your team.
- Discuss your pain control options with your doctors and nurses and make a plan.
- Talk to your team about realistic goals.
- In addition to different types of pain medicine prescribed by your doctor, plan to use non-medicine strategies.
- Talk about the schedule for pain medicines in the hospital and at home.
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: 07/22/2011
Copyright © 07/22/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7231
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