Although every patient experience is different, the majority of people having surgery will sustain some sort of acute postoperative pain for a relatively short period of time. But some will experience postoperative neuropathic pain (PONP), long-term chronic pain after surgery.
Depending on the type of surgery, somewhere between 10% to 50% of patients will have PONP afterward. However, with the right kind of pain management, or simply given enough time, this kind of chronic pain will go away.
It is difficult to determine the source of the signs and symptoms of chronic postoperative pain because different types of surgery can cause different complications such as damaged nerves, scar tissue, and or infection. And certain patients may have pre-existing conditions that can aggravate such post-surgery complications.
Such pre-existing conditions include:
- Having fibromyalgia or another chronic pain disorder
- Having rheumatoid arthritis or another autoimmune disease that can trigger pain symptoms
- Peripheral neuropathies
- Healing happens more slowly due to old age
- Having an anxiety disorder (anxiety is directly linked to chronic pain)
Some forms of chronic pain after surgery are due to a peripheral nerve injury. The peripheral nervous system links the central nervous system to every other part of the body. When a peripheral nerve is damaged during surgery, proper communication between the brain and the body is interrupted resulting in loss of sensation, muscle weakness, and pain.
Studies conducted by the Mayo Clinic suggest that nerve inflammation experienced after various surgical procedures may be a cause of post-surgical neuropathy. Previously this kind of postoperative pain felt in different parts of the body was attributed to stretching or compression of nerves during surgery. Their research concludes that some forms of post-surgical neuropathy are the result of the immune system attacking nerves.
It has also been shown that longer surgeries, those lasting for more than three hours, will more likely cause long-term postoperative pain. In addition, such chronic pain also shows up when additional therapy like chemo and radiation are used in combination with surgically removing cancer.
Patients with PONP are generally treated using medications, or other medical intervention, taking into account any other associated medical conditions they may have.
- Pain Relievers. Non-steroidal anti-inflammatory drugs (NSAIDs) like Tylenol can relieve mild symptoms.
- Pain Killers. Opioid drugs like tramadol or oxycodone can relieve moderate to severe pain. Please refer to a healthcare professional due to the risk of addiction
- Anti-Seizure Medications. Medications like gabapentin (Neurontin, Horizant) and pregabalin (Lyrica) can also relieve nerve pain. Side effects may include drowsiness and dizziness.
- Topical Medications. Capsaicin cream has been shown as an effective treatment for the symptoms of neuropathy as well as using lidocaine patches.
- Nerve Blocks. A nerve block is an injection of certain chemicals or anesthetics to the affected area that can inhibit certain nerve activity. It can also be performed by deliberately damaging parts of the nerve.
In particular, surgeries on the neck, back or joints, will most likely require a structured schedule of physical therapy and rehab to relieve chronic pain.
As previously mentioned, anxiety and other psychological factors might also add to the severity of pain. If this is the case, psychotherapy and psychotropic medications may be required.
The post-surgical patient experience might also include a good amount of mental stress. The worry that such pain might continue indefinitely can be extremely disheartening. Fortunately, for most people, this won’t be the case, but that fact isn’t going to keep people from worrying about it.
If someone is experiencing post-surgical neuropathic pain, there are several habits one can cultivate in order to better cope with the situation.
Such solutions include:
- Relieving stress by learning to relax. Such habits may include taking a warm bath, listening to soothing music, drinking hot tea, or watch your favorite comedy
- Keeping a pain journal. Recording when your pain occurs and where can help you and your doctor discover the source of your pain.
- Meditation. Using meditation you can use breathing exercises to identify sources of tension and focus on letting go of the pain
- Social support. Reaching out to others and sharing your feelings has been a proven method to reduce stress and alleviate pain.
Are you interested in participating in a clinical trial? We have a wide variety of clinical trials available if you qualify and meet specific criteria.