Prospective joint replacement patients should ask a surgeon questions about pain management just as they would ask questions about surgical procedures, estimated healing time, and physical therapy.

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Questions to ask include:

  • How much pain should I expect after surgery?
  • What is your approach to pain management?
  • What combination of painkillers will I be given?

    See Pain Medications for Arthritis Pain Relief

  • When does pain management protocol begin—before, during, or after surgery?
  • Does this hospital have a standardized pain management protocol?

This last question, regarding a hospital-wide pain management protocol, is not one that many patients think to ask. How hospitals approach pain management is discussed below.


How Hospitals Manage Pain

Some hospitals have a hospital-wide plan for managing joint replacement patients’ pain (health professionals may call this an institutionalized pain management protocol). The orthopedic surgeons, nurses, and other staff all follow the same general guidelines for treating pain. Research suggests that hospital wide pain-management protocols may have better outcomes.

An institutionalized approach to pain management does not mean doctors treat each patient exactly the same. Rather, doctors make decisions based on the same pain management model. Adjustments to anesthesia and pain medications are made and continually re-evaluated based on a patient’s individual physiology, overall health, and pain perceptions.


What if a hospital does not have a unified approach?
Many hospitals do not have institutionalized policies that guide joint replacement pain management. This does not mean that a patient’s pain cannot be managed well at these hospitals. Every surgeon makes the choices that he or she thinks is best for each individual patient.

Patients who are concerned about post-surgical pain management should talk to their doctors.

Dr. James Bried is an orthopedic surgeon with more than 30 years of experience in clinical practice. He specializes in sports medicine and adult reconstructive surgery. Dr. Bried also serves on the clinical faculty at University of California San Diego and on the editorial board for the Journal of Arthroplasty.

Dr. Brad Cohen is an orthopedic surgeon specializing in sports medicine and joint replacement surgery. He practices in San Diego, CA, and has more than 20 years of clinical experience. Throughout his career, Dr. Cohen has helped train dozens of fellows and postgraduate surgeons in complex surgical procedures involving the knee, hip, and shoulder.

Dr. Thomas Knutson is an orthopedic surgeon with more than 30 years of experience treating hip, knee, and shoulder injuries. He practices with Arch Health Medical Group in Escondido, CA, where he specializes in arthritis and joint replacement surgery.