• There is often a fear of addition when talking about opioid pain medication (hydrocodone) for treatment after surgery. Although this is a real problem, Dr. Palumbo uses an appropriate dose of opioid medication for the shortest possible time after surgery. Usually all patients are off this medication by 10 days after surgery, no matter the procedure. If there is any question regarding an increased dependency on the medication it is addressed during the post operative visits. He has also found that there are things other than strictly opioid medication that can help control post operative pain. It is preferred that there is no use of any opioid medication prior to the procedure. 
• Often times a regional nerve block is used prior to the procedure. This is done by the anesthesiologist at the surgery center. A dose of medication (Lidocaine) is injected around the nerves that control the arm under ultrasound guidance. It typically lasts for 18-24 hours after surgery. The benefit to this includes less medication needed during the procedure to control pain, less pain when waking up from surgery and the ability to start an oral pain management regimen prior to the most discomfort.
• Combining an over the counter anti inflammatory medication after the procedure is recommended for most post operative patients. These can work on different pain pathways and provide relief between doses of prescribed medication.
• Using ice and elevation (when appropriate) can also help with pain. While there are pneumatic pumps that can be purchased at our office with a cuff that fits directly on to the shoulder, you can also use a regular bag of ice. Continued use of ice after starting physical therapy exercises is also helpful.
• Dr. Palumbo has had positive feedback with post operative shoulder patient's using a MSK laser to help with pain control. While the laser is not a part of our clinic, it is located in our building and so it is very convenient. Benefits to the laser include help with post operative pain control, need for less  pain medication, improved experience with PT (can be done the same day), and an overall faster recovery.
• Although somewhat counterintuitive, physical therapy and early range of motion can also help with pain control. Stiffness in a joint can cause pain. Moving safely through a range of motion, even if it is not a full motion, can provide some improvement in discomfort. This is not advised on all procedures so make sure to understand if immobilization is required after the procedure you have had done.