Cold therapy units Ice Man (purchase) or Game Ready (rental) help decrease pain and swelling and the need for pain medication. They are designed to maintain a constant cool temperature over the joint or extremity where you are having pain and swelling. It is a small cooler that is filled with ice and water. A pad is applied over your joint with velcro straps. You are able to select a temperature that is comfortable to you and the device will maintain it constantly by continuously recirculating the ice water flowing to the pad. You will need to refill the ice every 3-6 hours. In this way it’s more convenient than ice bags which are messy, need to be refrozen constantly and can cause ice burns to your skin if not used properly. The representative from the company will call your home or see you in the office before surgery to discuss insurance coverage and cost of the unit.
Pain medication confuses many people. Opiates (aka narcotics) are controlled substances. These prescriptions must be hand delivered to the pharmacy. Before you run out let us know and we can write a new prescription. You/friend/family member can pick it up in our office.
Types of opiates (in order of strength)
- Oxycodone with acetaminophen (aka Percocet)
- Hydrocodone with acetaminophen (aka Norco, Vicodin)
- Tramadol (aka Ultram)
- Codeine (aka Tylenol with codeine)
Acetaminophen aka Tylenol is not an anti-inflammatory drug but it is a pain reliever. It is added to most opiates as an additional pain reliever. Do not take more than 3 grams of Tylenol in a 24-hour period. Doses over 3 grams/day can be toxic to the liver.
Types of NSAIDs (non-steroidal anti-inflammatory drugs)
Available over the counter: Motrin/Advil (aka ibuprofen, adult dose 600-800mg every 6 hours as needed for pain), and Aleve (aka naprosyn or naproxen, adult dose 250-500mg twice a day as needed for pain, Aspirin 81mg-325mg.)
Prescription only: Celebrex (aka celecoxib), Mobic (aka meloxicam), Diclofenac (aka Voltaren – topical gel or oral tablets)
It is OK to take the opiate and NSAID at the same time. Pain medication is prescribed as needed; therefore, if you don’t want to take it you don’t have to. It is meant to control your pain to help make your recovery be more comfortable. You will likely need pain medication at least for the first 2-3 days. You will not be completely pain free while your body repairs itself. Physical therapy can also be painful. Be prepared to take medicine before/after PT if needed.
We will prescribe an opiate for moderate to severe pain and recommend taking an NSAID (anti-inflammatory pain medication) for mild to moderate pain. You should start the NSAID the evening of the surgery and continue as directed until your post-op appointment or when pain has decreased.
Wean off all pain medication as soon as possible: wean off the opiate first, then the NSAID.