a key to successful post-operative rehabilitation
Pain is defined by the World Health Organization as “an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” After orthopedic surgeries such as knee replacements, hip replacements, and repair of hip fractures, pain management is essential during rehabilitation to maximize recovery and ensure the best possible outcomes.
A multi-modal approach to manage pain is employed on the musculoskeletal rehabilitation service at Helen Hayes Hospital. Each patient’s age, post-op course, and medical history is taken into account by the physiatrist, a medical doctor who specializes in rehabilitation medicine. This information is used to design a pain management regimen specific to each individual patient, to allow them to participate most effectively in the physical and occupational therapies necessary after orthopedic surgery.
A combination of long-acting pain medicine, short-acting pain medicine, anti-inflammatory medications, topical analgesics, and adjunct medications are used on a case by case basis to ensure that the patient is comfortable at rest, sleeping through the night, and able to tolerate therapy. A pain scale is used to rate the patient’s level of pain, which is continuously being evaluated by the doctor, nurses, and therapists to ensure the patient is comfortable. Each class of medication has a specific purpose for which it is used and by administering smaller doses of multiple medications rather than a large dose of a single pain medicine, complications and side-effects are minimized while pain is better controlled.
In addition to medicines, ice, heat, electrical stimulation, and ultrasound may be ordered by the physiatrist. Cryotherapy is used to minimize swelling and relieve pain in joints and soft tissue and may be safely applied to the site of surgery. Heat, electrical stimulation, and ultrasound may be used to treat muscle aches, back pain, and other musculoskeletal conditions that may arise during rehabilitation.
Fear of being in pain is one of the most common reasons that people delay the decision to undergo orthopedic surgery. At Helen Hayes Hospital, we are committed to minimizing your pain both during your stay and after discharge. In this way, you can achieve a great recovery and return to the activities you enjoyed before surgery.
Robert D. Holland, MD
Director, Musculoskeletal Rehabilitation Service