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Pain is one of the most common concerns patients have when considering a Periacetabular Osteotomy (PAO). Many people worry not only about how much pain to expect, but also how long it will last and whether it will be manageable.
While PAO is a major reconstructive surgery, pain is anticipated, closely monitored, and actively managed throughout recovery. Understanding how pain typically changes over time can help patients feel more prepared and less anxious going into surgery.
Understanding Pain After PAO
PAO involves carefully repositioning the hip socket to improve stability and joint mechanics. Because bone is cut and repositioned, it is normal to experience postoperative pain—especially in the early phase of recovery.
However, pain after PAO is not constant or static. Most patients experience a gradual shift in pain type and intensity as healing progresses. Early discomfort related to surgery gives way to soreness, stiffness, and muscular fatigue as mobility returns.
Importantly, pain does not mean something is wrong. It is part of the healing process and is expected to improve over time.
The Early Postoperative Period
In the first several days after surgery, pain is typically at its highest. This is when inflammation from surgery is greatest and mobility is limited. During this phase, pain is managed proactively in the hospital using a combination of medications and supportive care.
Patients are closely monitored, and pain control is adjusted as needed. The goal during this period is not to eliminate all discomfort, but to keep pain at a level that allows rest, safe movement, and participation in early physical therapy.
Most patients find that pain begins to steadily improve within the first one to two weeks after surgery.
How Pain Evolves During Recovery
As the initial surgical pain subsides, patients often notice a change in how discomfort feels. Sharp postoperative pain gradually decreases, while soreness related to muscle weakness, stiffness, and altered movement patterns becomes more noticeable.
This phase can feel frustrating at times, especially as activity increases. It is common to experience fluctuating discomfort as the body adapts to new mechanics and physical therapy progresses. These ups and downs are a normal part of recovery and do not necessarily indicate a setback.
Over time, many patients report that pain becomes more predictable and easier to manage, especially as strength and confidence improve.
How Pain Is Managed After PAO
Pain management after PAO uses a multimodal approach, meaning several strategies are combined to reduce discomfort while minimizing side effects.
This often includes a combination of medications, physical therapy, activity modification, and supportive techniques. Using multiple methods together allows lower doses of any single medication and helps patients stay more comfortable throughout recovery.
The approach is individualized, taking into account patient sensitivity, prior medication use, and overall recovery progress.
The Role of
Physical Therapy
Physical therapy plays an important role not only in restoring function, but also in managing pain. Gentle, guided movement helps reduce stiffness, improve circulation, and prevent secondary pain from muscle tightness or compensation.
Therapists also help patients learn safe movement patterns and pacing strategies, which can significantly reduce discomfort during daily activities.
While therapy can sometimes cause temporary soreness, it is a critical component of long-term pain improvement and recovery success.
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When Pain Should Be Re-Evaluated
Although discomfort is expected after PAO, certain pain patterns warrant reassessment. Patients should contact their care team if pain is worsening rather than improving, becomes sharp or localized, or is accompanied by new symptoms such as fever, redness, or swelling.
Open communication with the surgical team allows concerns to be addressed early and helps ensure recovery stays on track.
Long-Term Pain Expectations
One of the goals of PAO is to reduce pain caused by instability and protect the hip joint over time. While recovery requires patience, many patients ultimately experience significant improvement in their baseline hip pain once healing is complete.
It is important to remember that PAO is a long-term investment in joint health. The recovery process can be demanding, but it is designed to support durable pain relief and improved function.
Summary
Pain after PAO is expected, temporary, and actively managed. Understanding how pain changes over time—and knowing that support is available throughout recovery—can make the process feel more manageable.
If you have questions about pain management or concerns during recovery, your hip preservation team can help guide you through each phase.