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Time for Pain Meds? 

Pill Box: Exploring the ups and downs of pain management

click to enlarge John R. White chairs WSU-Spokane's Department of Pharmacotherapy.
  • John R. White chairs WSU-Spokane's Department of Pharmacotherapy.

My husband had knee replacement surgery and just came home yesterday. His surgeon prescribed a narcotic pain medication (oxycodone) and a non-steroidal anti-inflammatory medication (celecoxib, aka Celebrex). My husband is in pain but does not want to take his pain medication until he is in excruciating pain. What should he do?

Many people, and rightly so, are worried about addiction issues surrounding the use of narcotic pain medication. In cases such as your husband's, however, the best approach is to use the narcotic pain medication on a scheduled basis for the first few days, so that he is not "chasing the pain." Adequate pain management is important for wound healing, and also, obviously, for comfort. He does not need to be worried about addiction issues if he is following the doctor's orders for the short-term use of narcotic pain medication.

On the other hand, narcotic pain medications have myriad side-effects and should be discontinued as soon as the more severe post-surgical pain has abated. Initially, the management of his pain should probably include several other modalities, including ice packs, elevation of the leg and the use of the Celebrex. Together, these modalities should get him through the first days/weeks of his recovery.

One word of caution: Patients with a history of alcohol or drug abuse should make sure that their prescriber knows that this has been an issue with them. The informed prescriber can then develop a pain management regimen specific to that patient which will reduce the likelihood of further abuse or addiction problems.

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