PAIN MANAGEMENT AT HOME AFTER SURGERY

The goal of pain management is to reduce your pain so that you can participate in physical therapy and other daily activities
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Pain Management

Pain management - medicationsAfter your surgery, your discharge treatment plan will include prescriptions for oral pain medications. The goal of pain management at home after surgery is to reduce your pain so that you can participate in physical therapy and other daily activities.

If you have a pain management physician who is prescribing pain medications, plan to follow up with him or her within one month after discharge home from the hospital. We will provide pain medications while you are in the hospital and at discharge from the hospital. Your pain management physician will need to continue to prescribe your pain medications once you are at home.

Helpful Hints to Reduce Pain

  • Stay “ahead of” your pain; take pain medication before your pain gets out of control or it will be less effective
  • Consider taking your pain medication 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 incision area

Medications for Pain Management

You will be given several prescriptions before you leave the hospital. They will be for some of the pain medications, muscle relaxants, and/or anti-convulsants.

Narcotics

Narcotics are used to reduce pain and improve the ability to function and/or work. However, narcotics are also very addicting and long-term use should be avoided.

Your doctor will determine which medication is right for you. Dosage is every four to six hours for the first couple of days at home.

It’s important to gradually reduce the amount of narcotics that you take. Start by increasing the length of time between doses, then reduce the number of pills taken each time. You can expect a certain amount of discomfort until the inflammation and swelling goes down and nerve sensitivity decreases.

Most patients are off almost 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 spasms can be quite severe and painful due to muscle retraction and dissection during surgery. A combination of muscle relaxants, rest, and stretching can help manage muscle spasms. 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 of 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 that can also interfere with recovery and spinal fusion.

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).

If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis Institute at 214-556-0555 to make an appointment.