Managing pain before a hip or knee replacement

Information on managing pain if you’re waiting on a hip or knee replacement.

Understanding pain

Having a better understanding of pain can be very helpful if you’re living with it.

The public health campaign ‘Flippin’ Pain’ has information on persistent pain. This campaign was developed by a team of health professionals who work alongside people with chronic pain.

‘Flippin’ Pain’ is also available on social media through Twitter and Facebook.

Pain Science for Non-Pain Specialists


Exercise is a very good way of managing arthritis pain and improving mobility. It also won’t cause any further damage or harm to you or your joints.

Being physically fit and strong before hip or knee replacement surgery is also really important in supporting the recovery process. The stronger and fitter you are before the operation, the quicker your recovery will be.

Further information about exercise and arthritis can be found with Versus Arthritis. This includes a 12 week exercise programme called ‘Lets Move with Leon‘. This programme is made up of 30-minute movement sessions and is presented by fitness expert Leon Wormley.

Let’s Move with Leon

Types of exercise

For good overall fitness, strength and cardiovascular activities are important. Strength exercises include swimming and yoga. Cardiovascular activities include cycling and walking.

However, these are just examples of some activities and the best option for you may be different. It’s important to choose an activity you enjoy, and can stick to, to get the most benefit.

The Chartered Society of Physiotherapy has information on maintaining and improving strength.

You can also focus on moving a specific area with exercises for:

Speak to a physiotherapist or personal trainer for support and advice on the right exercises for you. They’ll also give you more information on how much exercise to do.

If you need further support, speak to your GP or clinician.

Using medication to control pain

There are lots of different types of pain relief to help joint pain, including paracetamol and NSAIDs.

Night time pain that affects your sleep is common in end-stage arthritis. Taking pain relief before bed may help to improve these symptoms.

However, for some, pain relief may become less effective over time. This is usually the case if you’ve reached the stage where you and your orthopaedic team are considering joint replacement. This means many people may need a different way to manage pain.

The charity Versus Arthritis has further information on different kinds of pain relief.

Opioid medication

Opioid medication can sometimes be prescribed by a doctor for severe joint pain.

Opioid medication includes:

  • co-codamol
  • tramadol
  • morphine

However, these medications can often have side effects, including:

  • constipation
  • drowsiness
  • long-term dependence

These side effects often get worse if you take opioids for a while or take them a lot.

Taking opioids before your operation can also be problematic. This is because it can impact on your recovery and increase the risk that you’ll have to continue to take opioids afterwards.

This means it’s really important to think about whether the pain relief you’re on is still helping. If it’s at all possible, try to slowly reduce the amount you take before the date of your surgery.

Injection therapies

Injections into the affected joint can sometimes be used to help relieve the pain from arthritis. This may provide short-term help but it’s not a cure.

If injection therapies are used too near to an operation, they lead to a higher risk of infection. However, if it’s going to be a long time until your operation, they may be an option to consider.