How to manage my pain at home after my hip or knee replacement

Pain after surgery is short lived and will get better even within the first few days after surgery.

Pain intensity can be rated according to how it interferes with your activities:  

Take your painkillers regularly for 5 days:
• Paracetamol tablets 1g 6 hourly
• Dihydrocodeine tablets 30mg 6 hourly
• Ibuprofen tablets 400mg 8 hourly for 3 days if prescribed (you may be prescribed Morphine Sulphate immediate release (IR) tablets 10mg 6 hourly for the first 24 hours instead)

On top of this regular medication you can take Morphine IR tablets 10mg up to 6 hourly (maximum 40mg in 24 hours) when/if you feel your pain interferes with concentration or makes you stay in bed.

If you have been prescribed Ibuprofen (your anaesthetist will decide if it is appropriate for you), you will also be given Omeprazole 20mg to protect your stomach lining. You should take this once daily and can be discontinued after 5 days once you have stopped regular use of ibuprofen.

Although your operated leg might feel uncomfortable, pain can be eased by carrying out your EXERCISES REGULARLY or by changing position.

In the first few days, it can be useful to take your additional pain killers an hour before doing your exercises to help with pain.

You can also use Ice packs regularly for up to 15 minutes several times a day to help reduce swelling, and keep distracted throughout the day.

After the first 5 days or earlier if you feel so:

• You can stop taking some painkillers while continuing with Paracetamol every 6 hours
• The first to be stopped are Dihydrocodeine and/or Ibuprofen (if prescribed)

If you feel your pain can be ignored you can:

A Stop taking regular Dihydrocodeine while continuing with Ibuprofen (if prescribed) and take Dihydrocodeine (up to 6 hours) just when you feel your pain interfering with task or concentration OR B Stop taking Ibuprofen (if prescribed)while continuing taking Dihydrocodenine every 6 hours and Morphine 10mg IR tablets (up to 6 hourly) when you feel pain interfering with task or concentration

• If after 5 days you still feel pain interfering with task or concentration - keep the same medication as from the beginning.

If you have not been prescribed Ibuprofen-follow option B

Some common side effects of pain killers include: 

• Nausea
• Vomiting
• Itchiness
• Headaches
• Drowsiness and
• Constipation.

For further information on side effects-please refer to manufacturer’s information included in each box of tablets

You may also be prescribed some additional medicines to treat side effects of pain killers:

• If you feel sick, you can take Ondansetron 4mg tablets up to 8 hourly

• To prevent constipation, you can take:

• Senna 7.5mg tablets

• Docusate sodium 100mg capsules.

Regular use of the above laxatives is recommended while you are taking Dihydrocodeine and/or Morphine tablets regularly. You can continue to use these as required for up to 2 weeks after your operation.

22-61 © RNOH

Date of publication: December 2018
Date of next review: August 2024
Authors: Dr Sean Nadaraja, Consultant Anaesthetist
Priya Patel-Lakhu, Specialist Pharmacist and Improvement Advisor