Fellow of the American Academy of Orthopedic Surgery
Member of the San Francisco Multispecialty Medical Group,
Part of the IPM Medical Group family
Board Certified, Fellowship Trained in Sports Medicine

Relieving Post Surgical Pain Without Narcotics?

Orthopedic surgery is painful.  There’s just no getting around the basic fact.  A lot of my patients, when they learn they need surgery, are more concerned about the pain, than the details of the actual surgery.  And almost no one really wants to be on narcotics.  Fortunately with multi-modal pain management (using smaller amounts of several medications rather than a whole lot of one) and regional anesthesia (blocking individual nerves and groups of nerves) the need for narcotics is a lot less than it used to be.

Every individual is somewhat unique in how they handle pain, and some of us need more medicine than others.  Some surgeries hurt more than others, too.  Most, but not all, orthopedic procedures will entail taking some amount of a narcotic, such as vicodin, for at least a day or two.  Some may not.  And it’s important to know that there are many strategies we can employ to try to minimize the use of narcotics – important for a lot of my patients who are allergic or just don’t tolerate them well.

I have several protocols that I use for various surgeries to try to make patients comfortable without overmedication.  These include the use of anti-inflammatory medications and milder pain relievers in addition to cold therapy and regional anesthesia.  Each of these approaches can be fine tuned for the individual.  When you are considering surgery, don’t be afraid to ask your surgeon about their plan for your pain relief.  Make sure your surgeon understands your concerns and your previous experience with medications so that together, you and your surgeon can come up with the best plan to keep you comfortable.

In my experience a team based approach allows for the plan best tailored to the individual, and in some cases for small procedures, allows a patient to manage without narcotics when that is their goal.