Celebrating Recovery Season with Proper Surgical Pain Management
As an orthopedic surgeon, the fall season holds special significance for me as it marks National Recovery Season—a time to support those in recovery from drug and alcohol addictions, as well as their families. It’s also a time to reflect on the importance of responsible and integrated pain management for my patients.
Many of my patients have shared their history with substance use disorder and expressed fear that their neck or back surgery could trigger a relapse. I’m certain that just as many patients, out of shame or fear, have stayed silent and possibly avoided surgery altogether. The key message here is that at NJNBI, we can plan your surgery and develop a strategy to manage your pain without jeopardizing your recovery. Perhaps most importantly, with so many families affected by addiction, there is absolutely no place for shame in our offices or operating rooms.
Opioid misuse has devastated countless lives, with over a million deaths since 1999. Many of these tragedies could have been prevented if not for the shame and stigma surrounding addiction. Fear of post-surgical pain is one of the main reasons people avoid operations that could significantly improve their quality of life. In reality, the pain is often less than expected, and avoiding necessary surgery comes with much greater risks than short-term pain management. These concerns create a delicate balance for us as healthcare providers: delivering life-changing care while managing the inherent risks of pain medications.
Surgery, while essential for alleviating pain, often requires opioid pain relievers during the recovery period. Though opioids have been used for nearly a century, their addictive nature is well-documented. For individuals in recovery from substance use disorders, the need for surgery can feel especially daunting. That’s why it’s critical for healthcare providers to approach pain management with compassion and without judgment.
Historically introduced in the 1840s, opioids exhibit diminishing effectiveness over time, leading to the risk of dependency. As responsible orthopedic surgeons, we aim to manage post-surgical pain effectively for the first 7–10 days, after which we collaborate with pain management specialists to continue care using integrated approaches. At NJNBI, we have built a trusted network of pain physicians who share our values, and when we refer a patient, we ensure they are in the hands of someone who puts patient care first.
There are many alternatives to traditional pain medications. These options may include physical therapy, yoga, stretching exercises, nutrition plans, meditation, and newer approaches such as CBD or physician-supervised cannabis therapy. By adopting a holistic approach to pain management, we can reduce reliance on opioids and provide safer, more sustainable alternatives for our patients.
In major back surgeries, developing a comprehensive pain management plan is a crucial part of the surgical process. This plan should be discussed and agreed upon between the patient and the surgical team well before the procedure. Transparency, honesty, and empathy are the foundations of this approach, ensuring the patient feels supported and empowered throughout their recovery.
Here are three key principles I follow as an orthopedic surgeon, which I believe all surgical candidates should consider:
You can safely undergo neck or back surgery and manage pain effectively. The long-term benefits of surgery far outweigh the short-term risks of pain management. Avoiding necessary surgery often carries far greater risks.
Honest and transparent discussions between surgeon and patient are essential. It’s important that your surgeon knows your history with substance use in order to assess risks and recommend appropriate pain management strategies. If you’re one of the 23 million people in recovery, a properly planned neck or back surgery will not jeopardize your progress.
Your surgeon should aggressively address post-surgical pain while being conservative in prescribing narcotics. Non-pharmacological options should be explored and discussed in detail.
As we reflect on Recovery Month, which just passed in September, it’s a reminder for us to take ownership of the surgeon’s role in the pain prescription cycle and recommit to the principles of responsible pain management and compassionate care. By fostering an environment of understanding and support, we can help our patients navigate the complexities of pain, addiction, and recovery with dignity and resilience. Together, we can continue building a future where every individual receives the care and support they need to heal, thrive, and reclaim their lives.