Archive June 2017 XVIII, No. 6

Ideas That Work: Herbal Post-op Pain Control

Homeopathic therapy

Herbal Post-op Pain Control

Yes, it's highly uncommon for a patient to leave an operation without an opioid prescription in hand, but since I opened my hernia center, I have prescribed opioids for less than 5% of my same-day surgery patients.

It's important to keep in mind that inflammation is the source of most post-operative pain: inflammation from the incision and inflammation from the tissue dissection (the mesh in hernia repair also adds to the inflammation). Opioids do not treat inflammation.

I use non-prescription anti-inflammatory medications to help reduce the need for opioids after surgery. This includes a mix of homeopathic herbal and vitamin pills that are safe and effective. The regimen starts before surgery to prep the patient's body to be low in inflammation and pain. Arnica and bromelain are excellent anti-inflammatory homeopathic regimens that don't interfere with surgical healing, bleeding or any other medications.

During surgery, I inject local anesthetic before making any incision. This has been proven to be beneficial regardless of the type of anesthesia (general or local with sedation).

Every patient gets an ice pack from me. Placing an ice pack directly on your wound for the first 1-2 days after surgery helps reduce pain, swelling and bruising. One French study even recommended starting the ice pack on the wound an hour before surgery. Most of my patients get a dose of an IV anti-inflammatory (Toradol) at the end of their operation. In addition to ice, my choice for post-operative anti-inflammatory regimen includes naproxen, arnica, bromelain, alpha lipoic acid, ginger, turmeric and Super B complex.

My non-narcotic regimen works for most, but not for all. About 15% of my patients suffer from moderate to severe chronic pain from their hernia or hernia-related complication. They often have their own pain management specialist who has been managing their pain. About half the time, my patients with chronic pain follow my non-narcotic regimen in addition to their baseline treatment, and they feel the difference. For the non-believers: I don't get many calls for pain control issues. And my patients are super satisfied with their pain control.

Shirin Towfigh, MD, FACS
Beverly Hills (Calif.) Hernia Center

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