Multimodal Pain Therapy Richardson, TX
Patients considering replacement of the knee or hip always ask the same two questions: 1) How much am I going to hurt? and 2) How long will I be out? The answer to the first is “a lot less than patients did in the past.” This is largely due to the use of lower doses of pain medications that work at different points in the pain pathway, known as “multimodal” pain therapy.
Traditional knee replacement surgery has been associated with lengthy and painful recovery. In the past several years, great strides have been made both in enhancing recovery and minimizing patient discomfort. Of these, pain control efforts deserve perhaps the greatest credit for the improved recovery now seen.
Better pain control that allows for earlier rehabilitation are the desires of both patients and their surgeons. Past attempts at pain control after joint replacement have included oral pain medications, mainly opioids, patient-controlled devices to deliver pain medications, mainly opioids, and indwelling spinal or peripheral catheters used to deliver pain medications, yes—mainly opioids.
The concept of multimodal pain control has to do with using multiple medications, each acting at a different part of the nerve pathway, combined with preemptive analgesia to better control pain at lower medication dosages. Literally, multimodal pain therapy involves treating pain before your surgery, during your surgery, and after your surgery. The results are more rapid recovery and, perhaps more importantly, less pain.
Despite the poor light that the popular press has presented opioids in, they are truly useful in the treatment of pain. It is well known that all medications have adverse effects that go hand-in-hand with their beneficial uses. This includes even the medications you can buy without a prescription. And often, higher required doses present correspondingly higher rates of adverse effects.
Opioids are the traditional drug class used to control truly severe postoperative pain. Adverse effects of opioid use can take the form of constipation, urinary retention, respiratory depression, and in relatively infrequent cases, the chronic use of opioids can result in dependence as so overwhelmingly chronicled in the news of late. However, the judicious use of opioids with adherence to your surgeon’s directions remain an important component of pain control.
More Is Better
As misleading as that statement seems, its intent is to refer to the use of multiple medications, each acting on a different aspect of the pain pathway which is the basis of “multimodal” pain therapy. The benefits of administering pain medications in a carefully orchestrated regimen are twofold; First, the effects of the different individual pain medications can be synergistic, resulting in each being more effective because of the other. Secondly, the synergistic capacity of multimodal pain therapy allows for effective pain control at lower doses of each medication, thus lowering the potential for adverse effects of each of the medications used.
Multimodal Pain Therapy at Texas Orthopedic Surgery Consultants
For patients undergoing total knee replacement or total hip replacement surgery, the control of postoperative pain starts before the surgery. In the holding area of the surgical wing, patients receive medications to help diminish components of the pain response under a nurse’s direction. During the surgery itself, pain control continues both with intravenous pain control as well as direct injection of pain control medications into the operative site to control the pain response at its origin. Postoperatively, the pain control efforts continue with a number of medications specifically designed to tailor dosage to individual patient needs.
Once ready to go home, each patient is provided with prescriptions and specific instructions for medications to continue pain control. The regimen is designed to control pain to better allow for advanced rehabilitation and will be reviewed at each postoperative visit with your surgeon. The goals of joint replacement at Texas Orthopedic Surgery Consultants are to restore function, regain mobility, and to relieve pain.