“What is the best painkiller after spine surgery?”

The following are my thoughts, and sometimes my tips and suggestions in response to your inquiry:

I heard spine surgery is a painful surgery. Post-operative pain medication may depend on the type of spine surgery you had. In any surgery type, the surgery is close to the nerves, and after any surgery there is an inflammatory response in the body. I am not an advocate of narcotic medication. I believe in Tylenol and an anti-inflammatory medication (with food, upon the approval of your spine surgeon), but also feel there are several other non-pharmacologic (not doctor-prescribed medication) treatment modalities that can help you get to a feeling of less pain. I like this link (https://www.pop-doc.com/joint-preactive.html) for more useful tips and suggestions, but let your decisions be influenced by your spine surgeon as well.

David T. Neuman, MD FAAOS

You’re a surgeon should be the one guiding you in that regard as there are many different kinds of spine surgery. Typically spine surgeons do not want patients taking standard anti-inflammatory such as Motrin and other members of the family if you had a type of surgery that includes a fusion of the bones. Tylenol is almost always permitted. Please contact your surgeon as it is the most safe and appropriate way to answer your question

Depends on the surgery you had. If it was a fusion, you do not want to use any NSAIDs as they can impair the fusion. The most potent opioid in oral form is dilaudid, however, that is typically not necessary. Most patients do fine with vicodin (hydrocodone) or percocet (oxycodone). If the surgery doesn't involve a fusion, then alternating tylenol with NSAIDs as soon as you can get away from the opioids is best.

The trend is away from heavy duty narcotics secondary to multiple reasons. First of which is potential for addiction and then many secondary side effects including respiratory depression and constipation. A combination of Tylenol Extra Strength and Celebrex can be effective in controlling moderate pain. If a narcotic is needed usually I recommend tramadol. Tramadol when combined with Tylenol is nearly as effective as Norco and far less addictive with far lower negative side effects. Many studies showed that patients do much worse when using heavy duty narcotics even in terms of recovery.