Pain Management

Pain after an injury or surgery is common. There are many ways to manage and reduce this pain that may or may not include medication. Each patient, surgery, and surgeon are unique, and the approach to pain management is different for everyone.

Discuss your concerns and expectations about pain with your surgical team before surgery. Asking questions and creating a plan can improve your experience. Your surgical team will have specific recommendations for you. Use this page as a general guide to discuss with your care team what methods will work for you.

Surgery Day

Before surgery, a nerve block can be given to numb the surgical area. A nerve block is an injection that can block pain to a certain area. Either your surgeon or anesthesia provider may perform this. A block may reduce the amount of medication you need during and after surgery.

As your surgery begins, you may receive medications by mouth or IV to dull the pain. Your care team will give you an appropriate amount of medicine during surgery to keep your pain under control, even if you are asleep. You may also receive medication in the recovery room after surgery.

Post-Surgery Pain Management

While it is always important to follow your doctor’s instructions, your team may recommend several methods to reduce pain after surgery.

Elevate: Inflammation and fluid will run to the site of surgery like water flowing down a hill. Elevating the injured area so it is higher than your heart can reduce swelling and pain by bringing the fluid away. Swelling can increase quickly by putting your hand at your side, and this can make your dressing feel tight.
Loosen your dressing: If your dressing or splint feels tight, and elevation for 10 minutes does not improve the tight sensation, contact your surgical team. It may be recommended that you unwrap tape or elastic wrap and loosen the outer bandage. If this does not help, you may be advised to tear, unwrap, or cut the inner layers with blunt-tipped scissors, cutting on the opposite side of the incision. Before doing any of this, check with your medical team.
Keep moving: If allowed by your surgeon, gently and slowly move the fingers, wrist, elbow, and/or shoulder that are outside of the splint or cast. This improves blood flow. It may be uncomfortable at first, but the discomfort will improve with time and motion. Your surgeon will be more specific about what to move and what to rest.
Ice the area: Icing the painful area can reduce swelling, inflammation, and pain. There may be certain procedures, such as surgery on arteries, skin grafts, or flaps, where a cold treatment could be harmful, so consult your surgeon before using ice.
Heat the area: If you are in the phase of care where you can remove your dressing or splint, heat may help. Heat increases blood flow to an area and can help with muscle spasms, muscle soreness, and joint pain.
Avoid smoking: Chemicals present in cigarettes can increase pain. Reducing or quitting smoking can improve pain. Nicotine alone can cause pain by reducing blood flow. For elective surgery, it is best to stop or limit smoking at least two weeks before surgery.

Post-Surgery Medication Management

The methods listed above are often effective when used in combination with medications after surgery. There are many different classes of medication that can help pain. Some can be purchased over the counter, and some require a prescription. Your surgical team will help create a plan with you.

Commonly prescribed or recommended medications may include:

  • Tylenol (Acetaminophen)
  • Aleve (Naproxen)
  • Motrin/Advil (Ibuprofen)
  • Celebrex (Celecoxib)
  • Toradol (Ketorolac)

Medication reminders

  • It may take 30-60 minutes for your body to absorb medication after taking it by mouth, so be patient.
  • Longer-acting medications used before bedtime may help you sleep better the first few nights after surgery.
  • The first few nights after surgery are generally the toughest.
  • Do not exceed the dose recommended by your physician or combine medications without consulting with your physician.

If you are unfamiliar with these medications, your surgeon can specify how much medication you should take, for how long, and how often. It is important to follow the directions of your surgeon carefully.

Opioids

Opioids are a type of pain medication made from the poppy plant that is used to make opium and heroin. They can be effective in treating pain, but opioids should be used as a last resort, in limited amounts, and for as short a time as possible. Use of these medications should only be done under the guidance of your doctor.

Oxycodone and hydrocodone are two commonly used opioid pain pills. Your pill may already have acetaminophen combined with the pain medicine, so make sure you are not taking too much if you take this separately. Your surgeon will give you a customized pain plan based on your type of surgery, number of procedures, duration of surgery, and other factors. Overdoses of pain medications can be dangerous and life-threatening.

Learn more about opioids, including side effects, safe use, and how to properly dispose of any extras.

This mobile-friendly version is adapted from patient education content originally provided by the American Society for Surgery of the Hand.