Orthopaedic surgeon Neil Sheth, MD, presents a detailed overview of the pain protocol now in place at Penn Orthopaedics. Dr Sheth’s discussion includes an examination of the etiology of bone and joint pain both before and after surgery, as well as recent efforts at Penn to transition away from traditional opioid-based management programs for acute postoperative pain. The latter involves multimodal protocols based upon the recognition of five distinct phases of pain control beginning at the initial patient encounter and continuing through surgery and beyond. At Penn, this approach has proved to provide better pain control, better patient satisfaction and lower overall narcotic consumption.