Managing Pain After Surgery

Managing Pain After Surgery

This explains what you can do to prepare for going home after surgery and to help your recovery. It
describes the medicines used to reduce pain, and how to use them safely while you recover.

Why have I been prescribed pain medicines?
Some pain after an operation or surgery is normal. The amount of pain will be different for everybody. It’s
known as acute pain and it can be lessened with pain medicines.

You will usually be offered pain medicines straight after your operation. Your healthcare team will develop a plan that includes pain medicines you may already be taking. These reduce the pain. This makes it easier
to cough, move, walk about and become steadily more active. These activities are vital to your recovery.

It is normal to feel anxious about moving again after surgery. As you recover and gradually increase your
activity level, you may notice that your confidence grows as well. It is important to have a plan to help you get there. Perhaps you might want to try something new or do things in a different way.

Pain medicines also make it easier to follow the exercise plan from your physio team, so you recover more
quickly. Being active reduces the risk of complications such as chest infection or clots in the legs or lungs.
As you feel better, stronger and are more active, you should reduce and then stop your pain medicines. If
pain persists, contact your healthcare team.

After your surgery
When you leave hospital, you will receive a pain management plan and a prescription for pain medicines.
The pain medicines will help manage your pain levels so you can be as active and independent as
possible. The pain levels will lessen as your body heals and you steadily increase your daily physical
activities in your home and outside.

If you are still struggling with high levels of pain even with pain medicines, you should ask for a review with your healthcare team.

What can I do after my operation to reduce pain and recover well?
Manage your medicines safely
Follow the advice on the best way to use your pain medicines so you make a good recovery. Remember to take pain medicines such as paracetamol and ibuprofen regularly.

Learn to pace your activity
Try not to overdo things just because you’re having a ‘good day.’ This is sometimes called a “boom or bust cycle” and is unhelpful for a steady recovery. It can make you overtired so that you can’t do anything the next day. Steady pacing of activities is better. Choose activities that help build fitness and do them at
regular intervals through the day. You’ll be more likely to keep it up if you choose activities that you find are fun or rewarding. Always stop before you get overtired and remember to build in rest breaks.

Stay active
Build up your physical activity and do enjoyable daily activities. Activity will help you distract yourself from
the pain. For example, you can: go for gentle, regular walks, do enjoyable hobbies or crafts, indoor or
garden activities (remember to do these within your recovery limits).

Distraction and other techniques
Use techniques such as watching fun or gripping films or TV programmes, practise mindfulness, use
crosswords and mindfulness colouring books, and try relaxation and breathing techniques.

How medicines reduce pain
Paracetamol is thought to relieve pain by blocking chemical messengers in the brain and spinal cord.
Non-steroidal anti-inflammatory drugs (also known as NSAIDs) such as Ibuprofen block the production
of certain body chemicals that cause inflammation and pain.
Opioids (for example codeine, tramadol and morphine) provide pain relief by acting on areas in the spinal
cord and brain to block the transmission of pain signals.

Opioids are considered to be some of the strongest pain medicines. You should reduce and then stop
taking opioids as soon as you can, or by the date on your pain management plan. This is because of the
risk of becoming dependent or addicted to them.

If you find it difficult to stop taking opioids by the time agreed in the plan, talk to your healthcare team to find other ways of stopping opioids and lessening your pain.

Using opioid pain medicines to prevent pain levels increasing
Using opioid pain medicines only when you need them will help you recover better. You’ll be able do more daily activities and keep to the exercise plan from your physio team.

Think about which activities are likely to increase your pain levels (for example, a longer walk or an outing
with friends).

You can then plan for these expected increases in pain by taking your strong opioid pain medicines before the activity. This helps keep pain levels controlled. It is the most helpful way to take strong opioids.

As your pain lessens, you can reduce pain medicines. Remember: you should aim to stop taking opioids
sooner than other pain medicines like paracetamol.

Constipation: a common side effect of opioids
Constipation is the most common side-effect of opioids and can really upset bowel movements. The most
helpful way to reduce constipation is to take action before you are severely constipated.

Three useful things to manage constipation well:

1. Drinking fluid helps. You should aim to drink plenty of fluids.
2. Eat foods that you know reduce constipation in you. For some people it can be figs, prunes, breakfast
   cereals, oranges, beans or pulses. Everyone is different.
3. Take a laxative medicine every day, to soften your ‘poo’ or stools and keep your bowels moving most
   days of the week. Get advice from a pharmacist or GP on the most useful type of laxatives. There are two types of laxatives: those that soften the stool and those that help move it through and out of the bowel. You might need to take both. Nearly everyone should take laxatives until they stop their opioids.
   

Stay safe while taking opioids after your surgery

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best placed
to answer any questions or resolve concerns quickly. If the relevant member of staff is
unable to help resolve your concern, you can contact the PALS Team. We offer informal
help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate
your concerns. You can make a complaint orally, electronically or in writing and we can
advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please
be aware that you may need to leave a voicemail message, but we aim to return your
call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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