Some pain is likely after discharge from the hospital. Narcotic pain medication is usually prescribed to help reduce the pain in the first 1 to 4 weeks after surgery. Because narcotic medications can be addictive and cause side effects such as nausea and constipation, it’s best to avoid using them for an extended time, however.

Walking as tolerated, drinking water, and adding fiber-rich foods—such as beans, bran cereal, fruits, and vegetables—can help prevent constipation. Many patients also need to use laxatives at this stage.

Acetaminophen, such as Tylenol, is the usual choice when narcotic pain relievers are stopped. Patients should check before taking any acetaminophen, however, as a number of narcotic medications also contain acetaminophen and too much can cause liver damage.

Certain drugs, known as nonsteroidal anti-inflammatory drugs or (NSAIDs), should not be taken for several months after surgery as they can impair the bone fusion process. Aspirin, ibuprofen, naproxen, and COX-2 inhibitors are in this group.

Some patients may be prescribed muscle relaxers. Before taking this medicine, it’s important to check with the surgeon or pharmacist about precautions and potential interactions with other medication or alcohol. Muscle relaxers are best limited to short-term use.

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If pain relievers and muscle relaxers aren’t working, or if there are any troublesome side effects, patients should contact their doctor.

Ice to Ease Pain

Pain relief is not limited to medication. Ice packs applied for 15 to 20 minutes each hour for 4 consecutive hours may provide significant improvement in symptoms. An ice pack may be especially helpful after any activity-related pain. A towel or other cloth should be placed between the ice and the skin to prevent an ice burn on the skin.

Patients usually visit the doctor at 2 weeks to get an assessment of the recovery so far and receive guidance on the next steps.

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Written by David DeWitt, MD