Pain after knee replacement is actually a very painful process and you need to follow your doctor’s instructions closely. I. Early postoperative pain relief While you are in the hospital, most pain relief is accomplished through pain medications given intravenously. These medications are very strong and can control most of the pain you can feel. After you go home, however, you won’t be able to give the medication intravenously. Your doctor may ask you to stay in bed for a few days, and you should do everything you can not to use your quadriceps or other muscles. During this time, there are several ways to relieve pain: 1. Oral medication The next step in the process of relieving knee pain will most likely be oral pain medication. Sometimes, for a few days after surgery, your doctor may prescribe some oral pain medications. Usually, these are COX-2 inhibitors (the prescription class of nonsteroidal anti-inflammatory drugs [NSAIDs]) or narcotic pain medications. These medications will help relieve your pain, but should only be used for a short period of time, as they can create a dependency and in some ways, they can hinder your recovery and bone regeneration in the joint area. Be sure to take these medications as prescribed by your doctor. 2. Other medications During this time, some doctors may actually only prescribe over-the-counter non-steroidal anti-inflammatory drugs. This is a normal route of treatment. Most of the time, your doctor will prescribe them based on your medical history, overall health status, and even age. Often, your doctor will prescribe aspirin or ibuprofen to help control pain. The advantage of these pain medications is that they do not create a dependency. If you occasionally have excessive pain, you can continue to use these medications for a period of time after surgery. Topical creams and ointments that contain some kind of analgesic ingredient can also be used. These are particularly useful at night and can help you sleep better at night. 3. Management of swelling and bruising After you have undergone knee replacement surgery, both swelling and bruising can occur and can make the knee area softer than normal. There are a few things you can do to keep the swelling and bruising within manageable limits. First, give your thighs plenty of rest after surgery. When the day is over, you will want to elevate your thighs on pillows for about 1 to 2 hours to prevent additional bruising, which will also help reduce swelling. Second, you may need to place an ice pack on your knee for 10 to 20 minutes after surgery, doing this 3 or 4 times a day. 4. Physical therapy Many patients need physical therapy after replacement surgery. Physical therapy is also part of knee pain relief. The exercises you do during treatment may seem challenging, but they will help you maintain full joint mobility and also help strengthen the important muscles in this area and keep you active. During treatment, your therapist may use massage to help relieve your pain. They may also use a device called a TENS (transcutaneous electrical nerve stimulator) in order to get more blood flowing to the area you are treating that day to control the pain. Second, it is important to keep your doctor informed of any side effects during your medication and treatment as part of your knee surgery rehabilitation program. Scary side effects include blood clots, joint, bone and nerve problems. For safety reasons, you should let your doctor know about your pain, any sudden changes you notice and any medication side effects you experience.