PAIN MANAGEMENT AT HOME AFTER SURGERY

Pain Management

After your surgery and you are discharged from the hospital, you will be given a prescription for oral pain medicines.  The goal of pain management at home is to reduce pain so that you can participate in physical therapy and other daily activities for a faster recovery.

You have a team helping you at the Southwest Scoliosis and Spine Institute and we will provide you with a pain management medication plan. We will provide pain medicines when you are in the hospital and provide a prescription for your pharmacy after your discharge.  Also, we will continue to proscribe your pain medicines and move to milder ones as you begin to heal,

Helpful Hints to Reduce Pain

• Stay “ahead of” your pain; take pain medicine before your pain gets out of control or it will be less effective.
• Consider taking your pain medicines at least 30 minutes prior to your physical therapy sessions.
• Apply an ice pack, not directly on the skin, and no longer than 20 minutes per hour — a bag of frozen peas wrapped in a kitchen towel works well.
• Change positions every 45 minutes during the day.
• Avoid prolonged sitting or standing in place.
• DO NOT use a heating pad on your cut area.

Medications for Pain Management

Our doctors will provide prescriptions for you when you leave the hospital. For example, these are pain medications, muscle relaxants, and/or anticonvulsants.

Narcotics

Narcotics are useful in reducing pain and improving the ability to function and/or work. However, narcotics are also very addicting and long-term use should be avoided.  Depending on many variables, your doctor will determine which pain medicine is right for you. Then for the first couple of days at home, the dosage is every four to six hours, and as you heal, less pain medicine will be needed.  You can start by increasing the timeline to take doses.  After that start reducing the number of pills that you consume each time.  In addition, you will feel a certain amount of discomfort until the inflammation and swelling go down. Also, you need to wait for the time till the nerve sensitivity decreases.

Most patients are off all narcotic pain medications by six weeks.

Narcotic side effects may include:

• Constipation
• Drowsiness
• Itchiness
• Nausea and vomiting
• Impaired judgment (do not make important decisions, operate heavy machinery, or do work at elevated heights while on narcotics)
• Muscle Relaxants

Post-operative muscle contractions can turn out to be severe and painful.  This pain occurs due to muscle retraction and dissection at the time of surgery. Moreover, a combination of muscle relaxants, rest, and stretching helps to manage muscle spasms. Furthermore, muscle relaxers are scheduled to be taken every six to eight hours. DO NOT stop muscle relaxants unless directed to do so as this will increase your pain.

Muscle relaxant side effects may include:

• Flushing
• Dizziness
• Drowsiness
• Metallic taste
• Nausea and vomiting

If you were prescribed Valium in the hospital for muscle spasms, it was as a supplement, not a replacement, for your scheduled muscle relaxant. Do not continue Valium once you leave the hospital because we cannot monitor you closely and those medications can have dangerous medication interactions.

Nerve-Stabilizing Medications (Anticonvulsants)

Patients who have nerve-related leg pain after surgery will be prescribed an anticonvulsant such as:

• Neurontin (gabapentin)
• Lyrica (pregabalin)

This class of medications decreases the number of pain signals sent out by damaged nerves. They relieve neuropathic pain (nerve pain) that can occur in arms, hands, fingers, legs, feet, or toes. Symptoms should gradually improve over time.

Anticonvulsant side effects may include:

• Drowsiness
• Fatigue or weakness
• Dizziness
• Headache
• Shaking from a part of your body that you cannot control
• Swelling of the extremities

Additional Information about Medications & Pain Management

IMPORTANT INFORMATION ABOUT OTHER MEDICATIONS, AND DIETARY AND HERBAL SUPPLEMENTS

Just as some medication and dietary and herbal supplements can affect patients during surgery, there are some drugs that can also interfere with recovery and spinal fusion. For instance, NSAIDs (anti-inflammatories) can impede the spinal fusion process. Do not take them or any medications containing them for at least six months after all fusion surgeries.  These include ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), meloxicam (Mobic), and oxaprozin (Daypro).