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Pain Management

About the Medications


Ibuprofen is a non-steroidal ant-inflammatory medication. The brand name is Motrin or Advil like medications. It is not only an analgesic but also anti-inflammatory.  It has a greater benefit in recovery than the narcotics. Please get the soft gel capsule version. It will be easier to swallow or to cut and mix with foods. 

Norco is a narcotic that comes in a tablet form  Generic name: hydrocodone bitartrate and acetaminophen tablet form is10mg/325mg. The maximum dose is 6 tablets/day.  You can break the tablet in half 

Acetaminophen. The  brand name is Tylenol. Use the Extra-strength 500mg/capsule. Generally take 1000 mg (2 capsules) every 6 hours. Remember that acetaminophen is NOT anti-inflammatory. Suggest getting the capsule (gel version if available). Tablets can be crushed.  The maximum dose is 3000mg (maximum of 6 per day for 500mg tablets extra strength.

About Controlling Pain 

  • It is not possible or safe to eliminate all pain. 
  • It can be reduced to a tolerable level. 
  • Stay on top of the pain. Do not allow the pain to become out of control. 
  • Use ice cold compresses. This will help reduce the pain 
  • Alternate the pain medications every 3 hours, especially the first 3 to 7 days after surgery 
  • It is better to take the pain medications in capsule form. The liquid equivalent can be a large volume and difficult to swallow. 
  • Take the pain medication with food: Crush/cut and mix in chocolate pudding or yogurt or apple sauce 
  • Use the prescribed narcotic to take away the pain, but the Ibuprofen will help reduce the inflammation from surgery.  The narcotic does not help with this. 
  • The narcotic can cause nausea, vomiting and constipation. These are side effects not an allergic reaction. Limit its use. 
  • By the second week after surgery, try to use only the Ibuprofen. Use the narcotic sparingly. 
  • By the end of the second week, the vast majority of our patients are off of all pain medications with only the occasional use of ibuprofen. 
  • By the third week, many of our patients are returning to school and to work. They will use gel or tablet form of the Ibuprofen as needed. Do not take narcotics at school or work. 

Guidelines Sample Pain Management Regimen

The following is only a sample timetable to be adjusted for dosage and times for each patient.  After the first 3 days, narcotic should be minimal or none. Please instead use Ibuprofen and Acetaminophen.

The First 3 to 4 days at Home
Use Ice cold compresses 
Alternate the narcotic with ibuprofen every 3 hours. 
Adjust the amount and timing

6AM        Ibuprofen   200mg (2-3 capsules) = 400-600mg 
9AM        Narcotic Prescription (Norco) 
12Noon   Ibuprofen   200mg (2-3 capsules) =400-600mg
3PM          Narcotic Prescription (Norco) 
6PM          Ibuprofen   200mg (2-3 capsules) = 400-600mg 
9PM          Narcotic Prescription (Norco)

After the first 3 to 4 days at Home 
Use Ice cold compresses as needed 
Please limit the use of narcotics. 
Adjust the amount and timing of Ibuprofen 
Begin using the gel or tablet form of Ibuprofen 
*If the Ibuprofen is not enough then use Hycet 
Many of our patients tell us they use the narcotic only in the evening. 

6AM       Ibuprofen   200mg (2-3 capsules) = 400-600mg
9AM       Acetaminophen  Extra strength 1000mg (2 tablets)
12Noon  Ibuprofen   200mg (2-3 capsules) = 400-600mg 
3PM        Acetaminophen  Extra strength 1000mg (2 tablets) 
6PM        Ibuprofen   200mg (2-3 capsules) = 400-600mg 
9PM        Narcotic Prescription (Norco)  

The Third Week at Work/School 
By now you should only need Ibuprofen. Do not take narcotics at school or work or while driving.