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Opioids After Orthopedic Surgery: A Physical Therapist’s View

Orthopedic surgeries, like knee or hip replacements, can be life–changing procedures that bring relief, improved mobility and function, and pain over time. However, managing pain after surgery often involves the use of opioids, a class of powerful painkillers. While often effective, opioids come with a host of risks, including addiction and other serious side effects. Some patients inevitably need surgery, but it's crucial to explore safer alternatives for managing post–operative pain.


The Risks of Opioids


Opioids work by blocking pain signals in the brain, but they also have a dark side. They can lead to:



  • Addiction: Opioids are highly addictive, and dependency can develop quickly.

  • Side Effects: These can range from drowsiness and constipation to more severe issues like respiratory distress.

  • Tolerance: Over time, you may need higher doses to achieve the same pain relief, increasing the risk of overdose.


The Research: What Studies Say


Recent studies have shown that 80+% of the research conducted on this topic involves randomized controlled trials, the gold standard in scientific research. The focus has been on reducing or eliminating the use of opioids after orthopedic surgeries.


While the scientific research still has considerable room for improvement in this area, the findings suggest that various opioid alternatives do indeed show promise in reducing opioid consumption, benefiting the patients, the broader medical community, and society.


Alternatives to Opioids


Non–Pharmacologic Methods



  1. Physical Therapy: As a proponent of physical therapy, we strongly believe that physical therapist–directed care after surgery is very important for patient education, pain control, and musculoskeletal disorders. Physical therapy can help improve mobility and strength, reducing the need for pain medication.

  2. Acupressure and Electrotherapy: These methods have been underused but show promise in pain management.


Pharmacologic Methods


NOTE: Physical therapy professionals do not prescribe medications, but we can comment on our experiences with patients. For answers about the most appropriate medications for you, please consult with your physician.



  1. NSAIDs and Acetaminophen: These over–the–counter medications can be effective for mild to moderate pain.

  2. Gabapentinoids: These are used in specific cases and must be prescribed by a doctor.


Making an Informed Choice


Opioids may be a common go–to for post–surgery pain relief, but they're not the only option. It's essential to discuss with your healthcare provider about alternative methods for managing pain. Physical therapy, for instance, offers a safer, effective route for many patients.


Need More Information?


If you have questions or need personalized guidance on managing post–operative pain, don't hesitate to contact your local physical therapy practice. We're here to help you make the best choices for your health.


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