Pain Control
Below are several different non-pharmacologic methods of pain control which are all supported and proven effective by scientific studies. Rely on these in your post-operative course to improve your satisfaction, decrease pain, reduce medication requirements, and reduce anxiety.
Music Therapy
Music therapy has many advantages for the postoperative patient. It has been shown to decrease overall pain, pain medication (analgesia) use, anxiety, and patient satisfaction. The best music for pain control is the music of your choosing, so listen to your favorite music!
Music also has a strong effect when used pre-operatively, so I recommend that you bring headphones to listen to music before your procedure.
All you have to do to partake in music therapy is listen to your favorite music. It is just that simple.
If you would like to read the literature yourself, here is a good article. This is a systematic review and meta-analysis published in the Lancet, one of the top medical journals in the world.
Cryotherapy
Cold therapy is most effective in the first 48 hours after surgery. It functions by providing a direct anesthetic effect and by lowering inflammation in the area it is applied. Studies have shown efficacy in both open and arthroscopic procedures, resulting in decreased pain and improved patient comfort. Overall it is safe and very cost-effective.
Although sophisticated cryotherapy machines exist, a simple bag of ice is a simple and effective method. If you're interested in something more sophisticated, there are several good options available on Amazon.
How to do it: Apply ice to the injury or surgical site for 20-30 minutes followed by at least a 10-minute break. Use a light towel between the ice and your skin to prevent frostbite.
REMEMBER: do not allow the ice to sit directly on your skin, and make sure your incisions and your postoperative dressings do not get wet.
Study on cryotherapy after ACL. Here is a literature review of cryotherapy after knee replacement surgery.
TENS Units
Trans-cutaneous Electric Nerve Stimulation (TENS) units are non-invasive nerve modulators. They're thought to work by blocking transmission of pain signals and/or raising levels of endorphins, natural pain killers. They work best when used during activities.
Studies have shown up to a 35.5% decrease in analgesic requirement when used post-operatively. Additionally, it has been shown to lower post-operative pain and opiate use. In hip fracture patients it improves mobility by decreasing pain with ambulation.
More information: https://my.clevelandclinic.org/health/treatments/15840-transcutaneous-electrical-nerve-stimulation-tens
Study examples: use after hip fracture, shoulder arthroscopy, and decreased analgesic use.
I do not recommend or vouch for any specific TENS units. I do recommend doing your own research on different units before purchasing. Here is a list of various TENS units: https://www.thegoodbody.com/what-is-the-best-tens-unit/
Sleep Therapy
Sleep and pain are intimately intertwined. Poor sleep at night results in higher perceived pain during the day and higher analgesic use. Additionally, poor sleep is associated with delirium, cardiovascular events, and overall recovery.
Methods to improve postoperative sleep:
Maintain a quiet and dim environment
Minimize sleep interruptions at night
You may benefit from ear plugs or a sleeping mask
Melatonin: this is a natural hormone the body creates that regulates your
circadian rhythm and sleep. It has been shown to help people fall asleep faster. It is safe with no side effects when taken appropriately.You can find this at most any pharmacy as an over-the-counter medication.
Adults should take between 1 and 5mg of melatonin about 1 hour before bed to help with sleep.
Here is a website by the Sleep Foundation with further information about melatonin.
This is a research article discussing sleep in the postoperative patient.
Interventions discussed below have all been proposed to help with pain control and may be beneficial to you as a patient. However, the literature does not provide the same support as it does for the interventions discussed above.
All of these interventions are inexpensive and have minimal or no side effects. I would encourage you to try them and see if they work for you.
Guided Meditation
Meditation has multiple impacts on people every day. It improves sleep and mindfulness, and can improve long-term outcomes after surgery.
Multiple studies have shown patients with higher levels of pre-operative pain catastrophizing have higher post-operative pain. Medication therapy pre-operatively can help reduce pain catastrophizing and therefore improve post-operative pain. There are small studies that show acute post-operative pain is improved with meditation therapy.
An article on mindfulness in hand surgery.
Another on mindfulness training prior to total joint arthroplasty.
Neurosurgery article discussing mind-body therapy after lumbar surgery.
Here are two youtube videos for you to try:
Aromatherapy
Aromatherapy is using specific smells to help control pain. There are multiple uses for aromatherapy around surgery.
Pre-operative anxiety can be improved with lavender and orange.
Post-operative nausea/vomiting can be reduced with peppermint oils.
Post-operative pain has mixed literature support. This means studies have shown improvement in pain and pain control satisfaction, while other studies have shown no difference. Lavender is most often cited in pain control aromatherapy. You may be a patient who responds well to aromatherapy for pain control, but it is hard to predict.
Here is a review of essential oil use for surgical patients.