Pain Management at Home Following Surgery (Adult)

Pain relief medicine works best when it’s taken as scheduled, usually every four or five hours. If you experience serious pain, which requires medicine more than five times a day, please call your care team.

It is hospital policy that you cannot drive yourself home after a procedure. Please make sure to set up a ride home. It is also not safe to drive while taking pain relief medications.  

About one hour before leaving the hospital, take a full dose of pain relief medicine. If you have a long drive and pain relief is needed, take medicine as prescribed during the trip. You also might want to stop often and reposition yourself. Repositioning promotes good circulation and ensures comfort. Be sure to use seat belts! Patients may be more prone to injury in a car accident after having surgery.

Below are just some of the things that indicate a person is in pain.

• Crying, screaming and/or moaning
• Complaining of pain
• Irritable, whiny, crabby or negative behavior
• Inconsolability (can’t be calmed)
• Major change in usual behavior (e.g., an active person becomes quiet or withdrawn)
• Inability to sleep or very restless, fitful sleep
• Big change in appetite, poor intake of food or liquids
• Cannot be distracted from pain
• Change in muscle tone, usually with increase in muscle tightness or spasms
• Inability to find a comfortable position
• Holds very still, seems to guard against touching or moving areas of the body that had surgery
• Unwilling to play or take part in routine or favorite activities

• Swelling
• Activity that has caused soreness or stiffness
• Stress, fear, sadness or anxiety
• Infection
• Poor sleep, exhaustion
• Constipation (no bowel movement in 24 hours)
• Urinary retention (no voiding in 8-10 hours) 

• Take another dose of pain relief medicine if enough time has passed since the last dose.
• If the pain is worse than usual, check to see if anything is wrong, using the checklist above.
• If you are not already using it, take stronger pain relief medicine, as ordered by your doctor, at the next dose. (Take the strong medicine instead of the other pain relief medicine, NOT in addition to it).
• Take the full amount of medicine, but no more than the prescribed dose.

• Distract yourself with music, stories, TV, video games, etc.
• Massage or use soothing touch on areas of the body that are pain-free.
• If possible, raise the part of the body that had surgery above the heart by a few inches. This will help reduce swelling and improve blood circulation.
• Use ice packs for 15 minutes at a time, with 30 minutes in between applications. Put a cloth in between the ice and skin to keep the skin from becoming too cold. Be sure to keep the cast dry.
• Encourage relaxation with slow deep breathing or guided imagery of a peaceful time. Relaxing can help lower muscle tone and promote comfort.

• Take a full dose of pain relief medicine about one hour before the cast is removed. There will be some discomfort when the cast is taken off. Bring your pain-relief medicine on cast removal day so you can take another dose of medicine, if needed.
• Swelling can continue for some time after casts are removed. Continue to elevate the arm or leg after the cast has come off.

Once you have become more comfortable, usually a few days after coming home from surgery, you can gradually change from strong pain relief medicine to a milder one. One good way to do this is to substitute plain acetaminophen, as directed, in place of stronger pain relief medicine. This is best done during the daytime.

If your pain is controlled, you may continue to take acetaminophen. If you are more uncomfortable at night, use the stronger pain relief medicine ordered by your doctor. Pain should decrease every day after surgery, and eventually you can stop taking even acetaminophen.

• Anticipate any big changes in activity that might result in soreness from overuse. Take pain relief medicine about one hour before doing exercises, standing or walking. It’s better to take pain relief medicine and encourage activity than to limit your activities.
• Increase activity gradually every day. If you start feeling less pain and become too active too soon, it may cause an increase in pain.
• Continue to elevate your legs or arms that had surgery, since normal circulation will be weakened for some time.

• Pain gets worse and there is new redness, swelling or thick drainage in the area of surgery.
• The location of pain changes for no reason (i.e., not due to physical activities or normal bumps/bruises).
• There is pain in an area covered by the cast, but not in the area of surgery. Sometimes casts can cause pressure in bony areas, such as anklebones, heels or the tailbone.
• Pain becomes severe and is not relieved by the methods discussed here. You may need to take two or three doses of pain relief medicine, about four hours apart, to get on top of the pain. It’s best to combine other pain relief methods, listed above, to get pain under control once it has become severe. But do not take more than one dose of the same pain relief medicine at a time, unless specifically directed by your healthcare provider..

Acetaminophen is contained in many common over the counter medicines. Always read labels to prevent taking too much of the drug. Limit acetaminophen to five doses in 24 hours. Do not take ibuprofen unless your doctor approved it for use after surgery.