Ask most people going in for surgery what their biggest fear is, and they’ll likely tell you it’s the post-op pain. That’s mostly because there’s so much uncertainty surrounding what to expect afterward.
“Every patient is unique in their fears related to surgery and specifically to their expectations of pain and pain management,” says Jonah J. Stulberg, MD, PhD. He’s an assistant professor of surgery at Northwestern University Feinberg School of Medicine in Chicago. “Some patients are terrified of becoming addicted to opioid medications. Others are terrified that their pain will not be adequately managed without opioids. Both are valid concerns. Your surgeon should address your fears directly and tailor your pain management accordingly,” he says.
How can you set yourself up for a more comfortable recovery?
Well before you head to the operating room, have an honest conversation with your doctor about your worries. Then map out your pain-management plan. Otherwise, your fears about the pain afterward could actually get in the way of your recovery. Patients who went into the procedure with more anxiety had more post-op pain, according to one recent study.
Keep in mind that every patient’s pain plan is going to vary. It will depend on several factors, including the specific operation, your pain history, and any other medication you’re taking. Here are some questions your doctor may ask you before your procedure, according to the American College of Surgeons (ACS):
- Do you or a family member have a history of substance abuse or overdose?
- Are you currently taking an opioid medication?
- Do you have a mental health condition such as depression, bipolar disorder or schizophrenia?
One thing that shouldn’t stand in the way of your pain relief? Cost. If you need help paying for your pain medication, Optum Perks can help. Download our app, search for your medication, and download a coupon for up to 80% off instantly.
How are the right pain medications determined?
In the world of surgery, not every pain is created equally. Different surgical procedures produce different types of pain, Dr. Stulberg says. For a simpler procedure, you may start with a combination of non-medication therapies (ice, elevation and rest) and non-opioid medications (ibuprofen, acetaminophen, aspirin).
“Nonsteroidal anti-inflammatory medications, such as ibuprofen, treat inflammatory pain better than opioids. They should be the first-line management for [this type of] pain,” Dr. Stulberg says. “While ibuprofen is an over-the-counter medication, some physicians will choose to write a prescription for a higher-dose formula.” Find the best price on prescription ibuprofen at a pharmacy near you.
For more complex procedures (which often leave patients in more pain afterward), your doctor might prescribe a multi-pronged therapy that begins with a short-term combination of opioids. Common opioids include:
- Tramadol (Ultram®)
- Codeine with acetaminophen (Tylenol® #3 or #4)
- Hydrocodone (Norco®)
- Oxycodone (OxyContin®)
Then after a few days, you’ll taper to non-medication therapy and non-opioid pain relievers. If you have nerve-related pain, numbing agents such as lidocaine, and gabapentinoids such as gabapentin (Neurontin®) or pregabalin (Lyrica®), are among the best treatments, Dr. Stulberg says.
“All surgical procedures will have a mixture of these types of pain. This is why the American College of Surgeons and other [groups] advocate for multiple approaches to pain management,” Dr. Stulberg says.
Indeed, using a variety of methods to treat pain has been found to be the most effective course, Dr. Stulberg says. “Starting with the lowest-risk methods before using higher-risk methods results in the best outcomes,” he says. “The question is not which one medication or nonmedication therapy is best. It’s which combination of nonmedication and medication is best for you, given your specific surgical procedure,” he says.
For a more detailed look at specific pain medications and how to use them, check out this very informative guide by the ACS.
How does pain progress after surgery?
The reality is that everyone experiences pain differently post-surgery. According to a study in Reviews in Pain, risk factors for chronic pain after surgery include a patient’s:
- Past medical history
- Past experiences
- Beliefs and life circumstances
- Type of surgery
- Type of anesthesia used
“Studies suggest that the most severe acute surgical pain starts at the time of surgery and lasts from 24 hours to 5 days,” Dr. Stulberg says. Plus, 9 out of 10 patients have only mild or no pain 4 days after their procedure, according to ACS. So go ahead and breathe that sigh of relief.
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