Managing Pain: A Guide for Patients Post Operative Knee or Hip Surgery

Why Pain Management Matters

  • Pain can affect your movement, sleep, mood, and quality of life.
  • Managing pain helps you stay active, heal, and take part in daily activities.
  • Pain management often works best when several approaches are used together.

Disclaimer: This list is produced for information purposes only. Effort is made to ensure accuracy, but as this information changes frequently, The Ottawa Hospital and its staff do not offer any guarantees regarding accuracy or completeness, nor do they endorse any specific service or facility.

Important Information

Alternative and Non-Medication Pain Treatments
These treatments are strongly recommended in Canada and may reduce the need for medications.

Physical Approaches

  • Physiotherapy
  • Gentle exercise and stretching
  • Heat or cold therapy
  • Massage
  • Assistive devices (braces, supports)

Psychological & Mind-Body Approaches

  • Cognitive Behavioural Therapy (CBT)
  • Relaxation techniques
  • Mindfulness and meditation
  • Stress management
  • Sleep improvement strategies

Lifestyle Strategies

  • Regular physical activity
  • Healthy nutrition
  • Pacing activities (avoiding overdoing it)
  • Good sleep routines

Discharge Planning

Your Role in Pain Management

You are a key part of your care and pain management:

  • Describe your pain clearly (location, severity, timing)
  • Use pain scales if given (0–10 scale)
  • Share your goals and concerns
  • Report side effects early
  • Ask questions if unsure

Post-Operative Care

Getting Around

Physical Approaches

  • Physiotherapy
  • Gentle exercise and stretching
  • Heat or cold therapy
  • Massage
  • Assistive devices (braces, supports)

Medications

Safe Use of Pain Medications

  • Take medications exactly as prescribed
  • Do not mix medications unless advised
  • Tell your provider about side effects
  • Never share prescription pain medicines
  • Store opioids safely and return unused pills to a pharmacy

Physiotherapy

Psychological & Mind-Body Approaches

  • Cognitive Behavioural Therapy (CBT)
  • Relaxation techniques
  • Mindfulness and meditation
  • Stress management
  • Sleep improvement strategies

Seek Medical Attention

When to Seek Medical Help

  • Get urgent help if you experience:
  • Sudden or worsening severe pain
  • New weakness, numbness, or loss of bladder/bowel control
  • Trouble breathing after taking pain medication
  • Signs of infection (fever, redness, swelling)

Questions or Concerns

If you have any questions or concerns, take a look at our Helpful Canadian Resources below.

Canadian Pain Education & Support
Pain Canada — Resources for People With Pain

  • A national hub for pain information, support, and education for people living with pain and their caregivers. It includes downloadable materials, videos, and links to local services → paincanada.ca .

2. Canada.ca — Chronic Pain Resources

  • The Government of Canada provides a page with national and provincial resources on chronic pain, self-management tools, and related support services.

 3. Power Over Pain Portal

  • A new online resource (built with national partners) designed to help people learn about pain, explore pain management methods, and access support tools. → The Ottawa Hospital
    (Note: this portal may be linked from the Canada.ca chronic pain page or partner websites.)

Shared Decision-Making & Wise-Use of Treatments

4. Choosing Wisely Canada — Patient Resources

5. Opioid Wisely (Choosing Wisely Canada)

  • Part of Choosing Wisely Canada’s campaign focusing on safe conversations about opioid use, risks, and alternatives for pain.

Physiotherapy & Rehabilitation Protocol

Procedures Covered

Understanding Pain

Pain can be:
  1. Acute – short-term (e.g., injury, surgery)
  2. Chronic – lasting longer than 3 months
Pain is personal. The goal is not always to remove pain completely, but to reduce it to a level that allows you to function and feel better.

General Principles

The Analgesic (Pain) Ladder Healthcare providers often use the analgesic ladder, a step-by-step approach recommended by the World Health Organization (WHO) and widely used in Canada.

Key Precautions

When using the Pain Ladder, it is important to note that:
  • Treatment can move up or down depending on pain control
  • Not everyone needs opioids
  • Non-medication treatments are used at all steps
  • Lowest effective dose is always preferred

Rehabilitation Phases

1 Step 1: Mild Pain - Non-Opioid Medications
  • Acetaminophen (Tylenol®)
  • Anti-inflammatory medicines (e.g., ibuprofen, naproxen)

✔ Used alone or with non-medication therapies
✔ Often first choice for mild pain

2 Step 2: Moderate Pain - Weak opioids + Step 1 medicines
  • Codeine
  • Tramadol

✔ Used when Step 1 is not enough
✔ Often combined with acetaminophen or anti-inflammatory medicines

3 Step 3: Severe Pain - Stronger opioids + Step 1 medicines
  • Morphine
  • Hydromorphone
  • Oxycodone

✔ Used for severe pain (e.g., cancer pain, major injury, post-surgery)
✔ Requires close monitoring

Notes for Patients

Interventional & Specialized Treatments

When other methods are unable to assist with pain management, the following interventions may be recommended for selected patients:

  • Nerve blocks
  • Injections
  • Pain clinic programs
  • Multidisciplinary pain management teams