Mega Doctor News
By American College of Surgeons (ACS)
Newswise – CHICAGO – Managing pain after an operation is an important part of healing and recovery. For most patients undergoing surgery, pain will be either mild or relieved within a few days following surgery.1 But for some patients, their pain may continue beyond the usual time and develop into chronic pain.2
“Pain can inhibit recovery, but good pain control can be an accelerator of a patient’s recovery,” said Jonah J. Stulberg, MD, PhD, MPH, FACS, a member of the American College of Surgeons (ACS) Patient Education Committee and vice chair of research for the department of surgery at UTHealth Houston.
Dr. Stulberg, who has researched effective pain control for more than a decade, offers these three tips for safely and effectively managing pain after surgery:
Tip 1: Discuss pain control with your care team before surgery.
“Bringing up pain control with your care team before surgery will help you come up with a plan and understand how much pain you can expect to have after surgery,” Dr. Stulberg said. “Having these conversations upfront can save you a lot of time and a lot of headaches after surgery, and it definitely helps with safety.”
He recommends asking your surgeon and care team questions about your care plan, such as:
- How much pain should I expect after my surgery?
- How should I manage that pain after surgery?
- When do I call if the pain is becoming too much or if I’m having trouble completing my daily activities?
Tip 2: Know your medication or therapies.
After your surgery, your doctor and care team can advise on effective ways to manage your pain that don’t involve the use of opioids, including:
- Over-the-counter medications such as acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®), which can be taken separately or together. Over-the-counter medications have been shown to be as effective as opioids for managing pain. “But these medications also need to be limited in certain instances and should only be used as prescribed,” Dr. Stulberg said.
- Therapies, such as heat, ice, and elevation, or complementary therapies like acupuncture and massage – Dr. Stulberg suggests speaking to your doctor about which one may be best for your specific circumstance.
- Exercise and rehabilitation therapies, which may be done in conjunction with occupational or physical therapy – “Certain movements will be allowed while others may need to be restricted to allow time for your body to heal,” Dr. Stulberg said. “These are conversations you can have with your doctor before surgery to help manage your pain.”
In some cases, opioid medications, such as oxycodone and tramadol, may be prescribed for severe pain after surgery, but these should be used with strict caution, stored safely, and properly disposed of following your surgical recovery.
“Opioid medications are really prescribed to that specific individual for the purposes of pain control from that specific surgery,” Dr. Stulberg said. “As we’ve seen with the opioid crisis, when those opioids are not used for the specific purpose that was prescribed by the physician, it can lead to misuse and tragic consequences.”
Tip 3: Talk to your surgeon about your pain.
Describing pain can be incredibly challenging since pain is very subjective. Dr. Stulberg recommends speaking to your care team about pain as it relates to function. For example, speak up and be as specific as possible if your pain is so severe that you’re having trouble taking a deep breath, getting out of bed, or walking to the bathroom.
“That type of pain can be severe pain and suggests we may need to control your pain better,” he said. “If your pain is constant but you’re able to take deep breaths and go about your day, that might be a level of pain you may need to tolerate for a short time after your surgery. That is the conversation to have with your surgeon.”
Some other questions to ask your care team:
- What should I be able to do after surgery?
- Can I wait to fill my prescription for opioids and see if I need it?
- What function should I expect in the days and weeks after surgery?
- How much should the pain be limiting me?
Always seek help if you feel that your pain has become severe. Pain after surgery, Dr. Stulberg emphasizes, should not be associated with:
- High fever (≥101 degrees Fahrenheit)
- Fast heart rate, which may be felt in the chest or throat
- Nausea and vomiting
“Those are all signs you should really be calling your doctor,” he said.
Pain control resources
The ACS has several resources for the public and for journalists writing about safe pain control management:
- Safe Pain Management for Adults
- Pain Management After Surgery for Women
- My Pain Plan Management Tool
- Safe Pain Management for Children and Teens
- How to Safely and Effectively Manage Pain (Video)
- ACS Statement on Opioid Abuse Epidemic
- Illinois Surgical Quality Improvement Collaborative – Opioid Reduction Initiatives
“We’ve learned a lot in the past decade, and many providers do a better job of checking things like prescription monitoring programs before prescribing opioids,” Dr. Stulberg said. “But each patient has unique pain needs – some patients do require more assistance with pain control, while others may have a higher pain tolerance or less of a sensation from the surgeries. Patient education continues to be front and center as an important component to creating a safer environment for pain control.”
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1Gerbershagen,et al. (2013). Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology, 118(4); 934-44.
2Glare, et al. (2019). Transition from acute to chronic pain after surgery. Lancet, 393:10180;1537-1546.
