Last reviewed: September 29, 2026

A few things help a little, and several popular ones have not been shown to help. Among pills, the non-opioid ones have the strongest evidence.

Acetaminophen and anti-inflammatory pills reduce pain and the need for opioids after a knee replacement. According to the American Academy of Orthopaedic Surgeons, both should be used. Anti-inflammatories are not safe for everyone, including some people with kidney disease or stomach ulcers. Gabapentin, often given for nerve pain, did not help and can cause drowsiness.

Nerve blocks, numbing medicine injected near the nerves at the time of surgery, reduce pain and the need for opioids. Some hospitals also send people home with a thin tube that keeps dripping numbing medicine for a few days. Compared with a single injection, reviews of trials found little or no added benefit, and a few more problems with the block. Some of these tubes weaken the thigh muscles and have been linked to falls. They are offered only where the anesthesia team runs such a program.

Among drug-free options, acupuncture and electrical nerve stimulation (TENS) have been tested after knee replacement. In a review of trials, electrical stimulation reduced opioid use, and acupuncture delayed the need for opioids and slightly lowered pain on the second day. A guideline covering all arm, leg and pelvic surgery found acupuncture may help but TENS made no difference.

Massage and music may help a little when added to usual care. Evidence on coping-skills therapy is mixed. Cold packs help a little in the first few days. Compression, guided relaxation, virtual reality and cannabis or CBD have not been shown to help.

Most of these benefits are small and last days to weeks.

In general:

  • Ask your surgeon which non-opioid pills are safe for you.
  • Ask before surgery what kind of nerve block you will have.
  • Acupuncture or massage can be added to your usual pain plan, not used instead of it.
  • Pain that is getting worse rather than better is worth reporting.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

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