Viewpoint and Experience with NSAIDs

By Mindi Dayton, DPM, MHA; Jesseka Kaldenberg-Leppert, DPM, MSA; Paul Dayton, DPM, MS

The team of foot and ankle surgeons at Foot and Ankle Center of Iowa/ Bunion Surgery Specialists was asked to share their viewpoint and experience with NSAID’s for pain control after foot and ankle surgery.

The authors noted that pain management following foot and ankle surgery is a primary concern for patients as well as surgeons. Traditional post-surgical pain management relies mainly on narcotic pharmaceuticals and, to a lesser extent, on non-prescription or non-pharmaceutical measures.

For over a decade, two of the authors (MD, PD) have employed a multimodal pain management regimen for their postoperative patients with great success. Adopting this multimodal pain management regimen came from a desire to provide patients with improved pain control while limiting the utilization of potentially addictive narcotics. According to the Centers for Disease Control and Prevention (CDC), more than 70% of drug overdose deaths in 2019 involved an opioid. A multimodal pain management strategy could help to prevent these deaths.

They shared that a priority in their rehabilitation philosophy for the majority of their surgical procedures is rapid return to both non-weight-bearing range of motion exercises as well as early weight-bearing to prevent the detrimental effects of prolonged immobilization.

The authors went on to share their post-operative pain management protocol, which involves NSAID’s as well as other medications and modalities to limit pain and narcotic use. They highlighted the research they have published with exceptionally high healing rates for bunion surgery in patients that have taken NSAID’s during their early post-operative course.

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