As the population ages, the number of patients with knee and hip arthritis due to degenerative changes in old age is increasing. Severe knee and hip arthritis seriously affects the quality of life of patients. Joint replacement can significantly improve joint function. It greatly improves the quality of life of patients. Many patients have repeatedly postponed seeking medical treatment for fear of intraoperative and postoperative pain. Is it always painful after joint replacement surgery? If the patient’s care team does not pay enough attention to pain and the patient does not receive systematic pain management. There is a high probability that the patient will experience more severe pain after surgery. On the contrary, if the patient’s team pays attention to perioperative pain management and has a series of effective analgesic measures, then the patient may have a very comfortable experience. Why does it hurt? There are many reasons for joint replacement pain, and the following are common: 1. lack of effective multimodal analgesia; 2. postoperative wound swelling; 3. postoperative infection; and 4. inappropriate type and placement of the joint prosthesis. Advantages and disadvantages of pain? Postoperative pain is a double-edged sword. Pain is a protective response of the body to injurious stimuli. However, severe pain can have a range of side effects, such as inducing adverse cardiovascular events. For joint replacement surgery, severe postoperative pain will affect the patient’s postoperative functional exercise, affect the recovery of postoperative joint function, and affect the surgical outcome. Good postoperative analgesia is very necessary. How to control postoperative pain after joint replacement? Post-operative pain after arthroplasty is relatively heavy, and controlling pain after this type of surgery requires systematic collaboration between the surgeon and the anesthesiologist. Pre-operative, intra-operative and post-operative analgesia and multimodal analgesia are used. Preoperative: patients are given preoperative education, have a correct understanding of pain, and take an appropriate amount of oral analgesics, such as COX2 inhibitors. The surgeon chooses the appropriate prosthesis and the appropriate surgical plan according to the patient’s condition. The anesthesiologist gives single or continuous peripheral nerve block according to the surgical site, such as femoral nerve block, lumbar plexus block, medial tubercle block, sciatic nerve block, etc.. The anesthesiologist will add appropriate amount of auxiliary drugs such as dexamethasone to prolong the analgesic effect according to the condition. Intraoperative: The anesthesiologist gives an appropriate amount of opioid before the start of surgery, including intravenous and/or intrathecal administration. Administering an appropriate amount of analgesic before the onset of a painful stimulus reduces the intensity of postoperative pain and improves the analgesic effect. Intraoperatively, the surgeon minimizes trauma to soft tissues and reduces operative time, and the anesthesiologist controls the patient’s blood pressure at an appropriately low and stable level to keep tourniquet pressures at a low level (230 mmHg to 260 mmHg) in an effort to minimize postoperative swelling of the affected limb and tourniquet-related pain. Before the end of surgery, the surgeon injects an analgesic mixture (local anesthetic, opioid and a small amount of glucocorticoid) around the joint to reduce local inflammation and painful stimuli. The anesthesiologist takes measures (perfect nerve block, sufficient central analgesics, etc.) to minimize the stimulation of the pain center by the peripheral tissue damage and to avoid sensitization of the pain center, depending on the type of anesthesia, throughout the surgery. Postoperative: The anesthesiologist gives the patient intravenous self-controlled analgesia or peripheral nerve block self-controlled analgesia according to the surgical site. The patient can take additional medication according to his/her own pain. The surgeon gives local cold compresses to reduce local swelling and local pain stimulation. Regularly give appropriate amount of non-steroidal anti-inflammatory drugs and central analgesics. Surgical department and anesthesiology department set up a special pain control group, patients who are not satisfied with the pain control can contact the group at any time, the group will also follow up with the patient regularly to give the necessary auxiliary treatment and help. In conclusion, pain control after arthroplasty is a systematic work, which requires multiple time points of intervention, multiple modes of analgesia, and good collaboration between departments. A comfortable medical experience can be fully realized. Perioperative analgesic measures for joint replacement