Post-surgical pain

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Pain is common after surgery. Pain, including post-surgical pain, is usually classified as either acute or chronic. Acute pain typically starts suddenly and is short-lived, whereas chronic pain lasts for longer than the expected healing time and can last longer than three months.

Recovering from surgery can be a challenging and painful process. If you’re finding that your pain post surgery has lasted longer than the normal healing time discussed with your surgeon or GP, then it’s worth speaking to your healthcare professional to investigate whether your pain is chronic, and how best to manage it.

Post-surgical pain can manifest in many different ways and there are several classifications of postoperative pain including the following:

• Nociceptive Pain — This is the most common type of pain post surgery and usually subsides as the area operated on begins to recover and heal. Nociceptive pain is a short lived and expected type of pain that is experienced when damage to tissue occurs during surgery.
• Neuropathic Pain — Also known as nerve pain, neuropathic pain is caused by damage to nerve cells during surgery.
• Referred Pain — This kind of pain is perceived to occur at another location other than the site of the surgery causing the pain. Referred pains happen because of the network of nerves in our bodies are interconnected, complicated, and can carry signals from different parts of the body.
• Phantom Pain — This type of post-surgical pain happens when there appears to be pain continuing in a part of their body that has been amputated. An example of this is when a patient might feel severe pain in their arm, despite their arm being removed during a procedure.

In this article, we will explore what post-surgical pain is, its symptoms, possible postoperative complications, and various management options for postoperative pain in Australia.

What is postoperative pain?

Post-surgical pain is the discomfort experienced after undergoing a surgical procedure. It can range from mild to severe, depending on several factors including the type of surgery, individual pain tolerance, and overall health.

In general, the amount of postoperative pain is related to the site of surgery and the extent of tissue damage. Symptoms of post-surgical pain include:

• Persistent pain in the surgical site
• Soreness and tenderness around the affected area, such as post surgery muscle pain
• Aching, throbbing, or sharp pain
• Limited mobility or difficulty moving
• Swelling and inflammation at the surgical site

What are the most common causes of post-surgical pain?

Postoperative pain can have various causes, including:

What are the potential complications or risks associated with post-surgical pain management?

Although uncommon, serious postoperative complications from post-surgical pain can occur. If you experience any of the following symptoms, it is essential to seek immediate medical assistance:

• Extremely severe pain that worsens or does not improve
• Infected pus coming from the surgical site
• High fever or a feeling of overall illness
• Restricted movement or inability to perform daily activities

Some medicines used in the management of pain may have side effects, such as sedation.

In some circumstances, people experiencing postoperative complications like post surgery muscle pain may transition into chronic pain if it lasts longer than three months. If chronic pain develops post-surgery, it is important to discuss this with various healthcare professionals, such as a GP, your surgeon, or a pain specialist.

Will I experience postoperative pain?

While most people feel at least some level of pain and discomfort in the post-surgery period, not everyone will experience postoperative pain. Some risk factors have been identified as predictors of postoperative pain include:

• Existing moderate-to-severe pain
• Repeat surgery
• Anxiety or fear of surgery
• Female gender
• Younger age
• Psychological distress
• Type of surgery (for example, some surgeries which require a longer duration may be associated with increased incidence of postoperative pain).

How can post-surgical pain be prevented or minimised?

Sometimes, it is impossible to prevent postoperative pain due to the very nature of surgery. Your surgeon will work with you to understand the risks associated with your surgery, including postoperative pain management and other postoperative complications.

How long does post-surgical pain typically last?

The duration of post-surgical pain can vary depending on several factors, including the type and extent of the surgery, your personal level of pain tolerance, and overall health.

In general, short-term or acute postoperative pain tends to last for only a few days to a couple of weeks. However, some people may experience pain for several weeks or even months after the surgery. It is important to follow the surgeon’s post-operative care instructions and take any prescribed pain medications to help manage the pain effectively.¹

What are the warning signs of excessive post-surgical pain?

Generally speaking, postoperative pain is short-lasting and tends to resolve as the surgery site heals. If you find yourself experiencing pain beyond the typical post-surgery period, speak to your surgeon or healthcare professional.

It’s also important that if you notice some of the potential complications or risks associated with postoperative pain management, like an infected wound, pus coming from the surgical site, or inability to perform daily activities, speak with your surgeon or healthcare professional so that they can help you manage your condition.

Is pain with stitches normal?

While stitches themselves are not typically painful after surgery, some people experience pain with stitches. The pain experienced after surgery is usually due to the underlying injury or trauma, rather than being a pain with stitches themselves. There may be some discomfort or soreness around the stitched area.

Several pain management strategies are available to help manage your pain with stitches in the post surgery period. If you are experiencing pain with stitches, speak to your surgeon or healthcare professional so that they can assess your condition and manage you accordingly.

Postoperative pain management

Post-surgical pain is a common yet often underestimated aspect of the recovery process experienced as a post surgical patient. It can cause discomfort and affect one’s overall well-being. However, with the various treatment options available, patients can often find relief and regain quality of life during the healing journey. Always consult with your healthcare provider for proper assessment and appropriate postoperative pain management strategies.

What are the best ways to manage post-surgical pain?

Post operative care can require an approach that uses multiple healthcare professionals, such as a GP, surgeon, or pain specialist to ensure the quickest recovery and best outcomes. Several treatment options are available to manage post-surgical pain, including:

It may also be beneficial to reach out to other people, such as community support groups or psychotherapy (counseling) to help understand your experience with postoperative pain, learn about life post surgery and how to manage postoperative complications.

Are there any exercises or physical therapy that can help in reducing post-surgical pain?

Yes, some evidence supports the use of physical therapy as a non-drug postoperative pain management. Targeted exercises and stretches can improve mobility and reduce postoperative pain. A physical therapist may work alongside your doctor and surgery team to recommend exercises which you can do post-surgery to manage your pain levels.

Medications for postoperative pain management

Postoperative pain management aims to minimise your discomfort as a post-surgical patient, help you get back on your feet, return to daily function, and prevent acute postoperative pain developing into chronic pain.

Maintaining control of your pain levels can support a faster recovery to full health and may help to prevent some postoperative complications, such as poor wound healing.

Most evidence supports the use of more than one pain management medicine and/or pain management strategy used in combination with one another. For example, your doctor may recommend the use of over-the-counter pain relievers like paracetamol to control pain and reduce your need to take stronger pain relievers.

Your surgeon may recommend treatment based on procedure-specific pain management guidelines. If you have any questions about the medications you have been instructed to use for post operative care, speak with your doctor or pharmacist.

What is the impact of chronic pain?

Chronic pain is common in Australia. Many Australians commonly see their GP for chronic pain, and over 100,000 hospitalisations each year are related to chronic pain.

In some circumstances, people experiencing postoperative complications like post-surgery muscle pain may transition into chronic pain if it lasts longer than three months.

Aside from experiencing pain itself, chronic pains such as postoperative pain can have negative impacts on other areas of your life including:

• Your strength and fitness.
• Your ability to work or perform usual activities at home.
• Your mental health.
• Your ability to make and maintain social connections.
• Intimacy.
• Your sleep.
• Your concentration.
• Your relationship with family, friends, and workmates. 

If you are experiencing chronic pain, including postoperative pain, it is important to note that you are not alone. There are tools, trained healthcare professionals and treatment strategies available for postoperative pain management. Effective pain control in the post-surgery period has been shown to reduce the risk of acute postoperative pain developing into chronic pain.

We spoke to Dr James Stewart, one of Australia’s leading minds in plant-based medicine who provided a medical view about post-surgical pain.

FAQs

Below you will find an independent telehealth clinic with a team of healthcare professionals trained and experienced in acute and chronic treatments, with expertise in post-surgical pain management.

If you wish to consult a doctor who is familiar with supporting your post operative care, choose your preferred option to book an appointment and discuss your condition. 

Click below to learn more about each condition, traditional treatments, and alternative options you may wish to consider.

References:

1. Health Direct. Pain relief after surgery. Available at https://www.healthdirect.gov.au/surgery/pain-relief-after-surgery
2. NPS Australian Prescriber. Postoperative pain management. Available at https://www.nps.org.au/australian-prescriber/articles/postoperative-pain-management-1