Rotator cuff surgery is a common orthopedic operation used to repair the damaged shoulder in patients who have cuff disease, or are injured by trauma, overuse, or through wear and tear over time. It can often be performed arthroscopically, with only a small two-inch incision for larger instruments as needed. Despite the small incisional area, the shoulder will be quite painful for many weeks after surgery, because of how much we use the joint without even realizing it. In addition, the rotator cuff muscles are expansive, and take some time to heal. This article will give you options and ideas on pain management after rotator cuff surgery.
The function of pain medication after rotator cuff surgery is to limit the brain from feeling the pain from the incision and from the operating area. Pain medications block the pain receptors and dull the messages being sent from the nerves to the brain. By numbing the feeling, the brain does not overreact by sending the body into shock, and also does not cause the patient to feel stressed. The first 48-72 hours after surgery are the most critical for this portion of recovery, which is why the heavy doses of pain medicine are saved for this period, and usually given in the hospital by professional staff. Medicines such as morphine and injectable anesthetics are given during this time period, while the body adjusts to the surgery and begins the healing process.
Before the patient is sent home, he will have been transitioned from injections to oral medications. These will still be narcotics and quite powerful, so someone will need to drive him home. No driving should be attempted while narcotics are used to control pain. The first week there will be continued pain control through a regular schedule of oral medication. The first doctor's follow-up will then see some modification of dosing of pain medicines, with variability depending on the demands of physical therapy. The idea is that the further you are away from your surgery time, the less pain medicine you should take. There will be bad days where you may need more, but there should be good days when you need less.
Physical Therapy - Ouch!
Physical therapy is a key part in the successful recovery from rotator cuff surgery. It will begin within 24 hours of the operation, and continue for several months. Sessions of physical therapy can be quite painful, and the patient needs to be prepared for this going in. Many physical therapists will instruct their patients to take a full dose of their pain medication about half and hour before their PT session. This allows them to reap the full benefits of their workout and not be inhibited by the pain that is caused by the exercises. As time progresses, the PT will have the patient switch from narcotics to over the counter medicines, such as Tylenol, Ibuprofen, Aleve, and so on. However, taking a pain reliever before a session with the physical therapist is always a good idea.
Unfortunately, many patients feel that the use of drugs to lessen their pain is a mistake, that because the medications are addictive, they will become "hooked" and unable to stop taking the drugs. While the addiction of narcotics can happen, the truth is that if you are under the care of a professional physician, and are following the guidelines given to you, your use of the narcotics is not dangerous, and will help you more than hinder you. Pain medication can help you heal faster, stronger, and better. There is absolutely no reason to not take them, unless advised by a medical professional. As long as you are following dosing instructions and - most importantly - not using them when you do not need them, your use of pain medicines is a necessary step in your recovery from rotator cuff surgery
On the flip side of the above paragraph, you do need to be very aware that the abuse of pain medication is no joke. Taking too much pain medicine can easily kill you, as these medications slow breathing, slow the heartbeat, and make consciousness foggy at best. Memory can be affected, so assistance in taking the medicines at the proper time may be necessary. Driving is out of the question if a patient is taking narcotics, and remember you can go to jail if you test positive for narcotics if you are pulled over for questionable driving. Pain medication slows your reaction, and impairs your judgement. And yes, pain medication is highly addictive. It is a very simple thing to become dependent on the medicine to feel good. More and more is needed to maintain that good feeling. And before you know it, you need it just to feel normal, and then it is all downhill from there. If you have any questions about whether or not you may be abusing the pain medicine given to you for your rotator cuff surgery, see your doctor.
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