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Pain medication: your questions answered

Top 10 questions about pain medication

Please click a question below to view the answer. 

1. How often should I take pain medication? 

Take pain medication if your pain is stopping you from doing the exercises you were told to do by your physiotherapist or if you aren’t moving well at home. Generally, your body will tell you when you need medication for pain; you should take your pain medication at least 30 minutes before activities that may increase your pain. If pain is interfering with your sleep, you may benefit from taking pain medication before sleeping.

Caution

Do not take pain medications only for the sedation (sleepy) or mood lifting effects. This may increase your risk for addiction. Sleep problems must be treated differently. See Question 7, 8.

2. How long will I need pain medication? 

Every person is different in their need for pain medication. Some patients may require 6 weeks of regular medication with a weaning (or lessening) of pills over time. Other patients may require medication for only one to two weeks. Most patients are somewhere in between. It is important that you do not suddenly stop your pain medications if you have been taking them on a regular basis, see Question 9 to learn about how to wean off your medication.

3. What if I am running out of pain medication? 

If you are still having pain, do not wait until your pain medication is almost done; call your surgeon’s office 3 to 4 days before it is finished. If you have already had your first follow-up visit then call your family doctor who can help you get the right medication for your pain.

4. What other pain medications can I take with the medications my surgeon prescribed? 

Medications for pain relief after surgery belong to three groups – opioids, acetaminophen, and anti-inflammatories (details in "about your pain medication" below). By using pain medications from each of these three groups, it often will reduce your need to take as much opioid medication (which has the most side effects). Always follow the directions on the label of the bottle.

5. Can I take pain medication with my sleeping pills? 

If you were taking opioid pain medication with sleeping pills in the hospital without any problems, it is safe to continue doing this at home. Do not increase the amount of either medication you are taking. If you are starting a new sleeping pill after you left the hospital, speak to your family doctor and tell them that you are also taking opioid pain medication.

6. What should I do if my pain medication isn't working? 

Check the directions on the label of the pain medication bottle and review this pamphlet to make sure you are taking the medication properly. If you are not sure, ask your pharmacist. If you continue to experience problems with pain before your first follow-up visit, then call your surgeon’s office. It is important that they know about your pain as they may want to see you to make sure you are healing well.

7. What are side effects of the opioid pain medications? How do I manage them?

Constipation (hard bowel movements)

  • Drink more liquids, you may also find prune juice helpful
  • Eat foods that are high in fiber (e.g. fruits, nuts, beans and whole grain bread)
  • Slowly increase your activity
  • If your constipation lasts more than 2 days, you may need a laxative or suppository to help your bowels to move. Talk to your pharmacist or family doctor about what medication would be best for you. You may have been given Senokot® or Lax-A-Day® while you were in hospital. You can buy these laxatives over the counter at the drug store.

Nausea and/or vomiting (stomach upset)

  1. Take your pain medication with food.
  2. Ask your pharmacist or family doctor to recommend something to settle your stomach.
  3. If your pain level is okay try taking a smaller amount of pain medication, for example one pill instead of two.
  4. If this does not help, please contact your surgeon. The pain medication may need to be changed.

Sleepiness, confusion or dizziness

Stop taking your opioid pain medication and call your surgeon if you are confused, very dizzy or too sleepy to do your daily activities (e.g. falling asleep while eating). If your pain medication makes you a little sleepy or dizzy, try taking a smaller dose, for example, one pill instead of two. If less medication does not help, please call your surgeon. The pain medication may need to be changed.

8. Will I become addicted to opioid pain medication?

The risk of addiction is very low. It is important to wean yourself off (slowly reduce) taking the medication when it is no longer needed to allow you to do your exercises or move around your home easily. If you find it difficult (for reasons other than pain, such as the effect on your mood and sleep) to wean off your opioid pain medication, please contact your surgeon or family doctor.

9. I think I am ready to stop taking the pain medication, how should I do this?

Do not stop taking the opioid pain medication suddenly. Wean off your medication slowly to avoid withdrawal symptoms (sweating, fever, shaking, nausea and/or vomiting, diarrhea, more pain, anxiety, feeling tense, worried or irritable etc.)

Withdrawal symptoms are not a sign that you are addicted. If you experience any of these symptoms when you are weaning off your medication, you may be reducing the amount you are taking too quickly.

When you are ready to start weaning off the opioid pain medication, follow these steps:

Step 1:

Wait for a longer time between taking pills. For example, if you have been taking pills every 4 hours:

  • Take the pills every 5 to 6 hours for 1 or 2 days
  • Then, take the pills every 7 to 8 hours for 1 or 2 days

Step 2:

Start taking less medication each time:

  • If you are taking 2 pills each time, start taking 1 pill each time for 1 to 2 days
  • If you are taking 1 pill each time, cut the pill in half and take only half a pill each time for 1 to 2 days

Adapted from: weaning off your pain medicine by TWH


The above instructions do not apply if you are taking long acting pain medication such as OxyNeo®, Hydromorph Contin®. Please visit your family doctor to discuss a plan to wean off your pain medication.

10. Can I use creams to help with my knee pain (e.g. Voltaren®, Arnica®, Tiger Balm®)?

To avoid infection, do not put anything on your incision until it is well healed and there are no longer any scabs. It is okay to use these creams as long as you avoid putting them near or on your incision.

Along with your pain medication, there are other ways you can reduce your pain

  • Make a daily plan to exercise and be active but include rest periods between these activities. Increase your activity slowly so that you don’t increase your pain.
  • Walking is a good activity after surgery, but don’t do too much or your pain may increase. For example, try to walk for 5 minutes. If your pain does not increase, try walking for 6 minutes the next day.
  • Put ice where you have pain. Use ice for up to 10 minutes every hour, as needed.
  • When resting, lie flat and elevate your leg above the level of your heart to reduce swelling, pressure and pain.

About your pain medication

Opioid

If you were prescribed an opioid combination medication (e.g. Percocet, Tramacet, Tylenol #3), these already contain acetaminophen (Tylenol®) therefore do not take more Tylenol®. Unless directed by a doctor, mixing pain medications from the same group e.g. Hydromorphone® and Codeine® can be dangerous and may increase side effects.

Types of opioids

Short Acting*

  • Hydromorphone (Dilaudid®)
  • Oxycodone
  • Codeine
  • Morphine IR (Statex®)
  • Tramadol IR (Ultram®)

Long Acting**

  • Hydromorph Contin®
  • OxyNeo®
  • Codeine Contin®
  • Tramadol ER (Zytram XL®)
  • Morphine SR (MS Contin®)

Opioid Combination

  • Percocet® (Oxycodone and Acetaminophen)
  • Tylenol® 1, 2, 3 (Acetaminophen and Codeine)
  • Tramacet® (Acetaminophen and Tramadol IR)

* Short acting (IR) means the medication starts working quickly but doesn't last as long
** Long acting (ER/CR/SR) means the medication lasts longer but takes more time to start working.

Acetaminophen

If you were given Tylenol® in hospital then you can continue taking 1-2 pills of Extra Strength Tylenol® (Acetaminophen) every 6 hours for 7 days after surgery (then take as needed). Do not take more than 4g (8 pills of Extra Strength Tylenol) in a 24 hour period. While taking Tylenol®, do not take opioids that also contain Tylenol® such as Percocet® or Tramacet®.

Types of acetaminophen

  • Tylenol®
    • Regular strength = 325mg/tab
    • Extra strength = 500mg/tab

Anti-Inflammatory

An anti-inflammatory can help with swelling (which may reduce the pressure) and pain in your leg. If you tolerated antiinflammatory medication (Celebrex® or Naprosyn®) while in the hospital and your surgeon has prescribed it, it is safe to continue taking this daily for another two weeks even while taking the blood thinner (Rivaroxaban®) prescribed by the surgeon.

Types of anti-inflammatory

  • Celecoxib (Celebrex®)
  • Naproxen (Aleve®)
  • Ibuprofen (Advil®)
  • Meloxicam (Mobicox®)
  • Diclofenac (Voltaren®, Arthrotec®)
 

Tracking your medication

Use a medication tracking sheet as you start to reduce your medication. 

» Download now