Surgery is a stressful experience, largely because of the potential for pain associated with surgery. Pain after surgery is common, with 86% of people reporting moderate, severe, or extreme post-operative pain.
In most cases, pain after surgery is expected.
Ultimately, surgical procedures help people stay healthier. However, any surgical procedure is still a form of trauma in itself. Tissue and nerves are damaged and must go through a healing process. Just as a cut or burn continues to hurt while it heals, so too can a surgical site can cause pain. This helps remind the body to be careful of the injured area during the healing process.
However, just because pain after surgery is normal, it doesn’t mean that uncontrolled or extreme pain is unavoidable. There are several ways to reduce and manage pain after surgery.
Minimizing pain after surgery begins before the surgery occurs.
In some cases, it isn’t possible to plan ahead for surgery. Emergencies or accidents can necessitate surgery with no warning. If a surgery is planned in advance, though, thinking ahead a bit can help significantly reduce pain after surgery.
Pain catastrophizing, or a fear of pain, has been identified as a risk factor for pain after surgery. This means that being overly afraid of the possibility of pain can actually lead to worse pain. The best way to reduce a fear of pain is to know what to expect. Have a list of questions prepared before going in for your surgical procedure, such as:
- Where on my body am I likely to experience pain? How intense might the pain be at its worst?
- Are there any specific types of pain that could indicate a problem?
- Is there anything I can do in advance to reduce my pain after surgery, such as physical therapy or a change in diet or medications?
- What methods of pain control will be used during and immediately after surgery, before I’m discharged?
- After I’m discharged, will I be provided with a phone number for a 24-hour on-call medical professional, in case I have questions about my pain?
- Are there any activities I should avoid after surgery? How much physical activity should I do after my surgery, and what kind?
Honest, thorough discussion with your physician and surgeon is a necessity. Bring up any chronic pain conditions you have. Provide a list of all medications, supplements, and vitamins you take. Also mention any previous experiences with pain medications, particularly if you experienced negative side effects – such as severe nausea or slowed respiration.
Additionally, anxiety and depression are known risk factors for pain after surgery. Let your physician know if you’ve struggled with mood disorders, as well as any treatments you’ve undergone.
One study has also found that music can reduce both pain and anxiety after surgery. Listening to music before, during, and after a surgical procedure can be beneficial, even while under anesthesia. If you enjoy music, bring along a portable mp3 player and a pair of headphones. The type of music makes no difference, as long as it’s something you enjoy.
Continue to communicate openly with your physician or surgeon after surgery.
Before being discharged, let the nurses or physicians know if you’re experiencing severe pain. It may not be possible to fully get rid of the pain, but there’s no reason the pain has to be severe. Don’t wait until the pain is very bad before mentioning it. Medications can take a while to kick in, by which time the pain could have worsened even more.
Take advantage of your time in the hospital by asking questions about how to manage your pain after going home. Ask for handouts and notes on medications, suggested activities, and contact numbers.
After you’ve been discharged, follow your instructions carefully.
Move when, how, and as often as you’ve been told. If this means doing physical therapy or exercises, do so. These physician-ordered exercises are designed to strengthen the body and speed recovery.
Keep on top of your medications. Since you’ll likely be utilizing oral pain medications after going home, be careful not to let your pain get too bad before taking your medication. Oral medications tend to take longer to have an effect, as compared to the IV or injected pain medications commonly utilized in hospitals. Consider setting a timer to make sure you don’t miss a dose, at least for the first couple of days after you’re discharged.
If your pain seems to be more severe than your physician said it would be, call and let him or her know. It could be indicative of a problem, or it could simply mean that your current pain control method isn’t effective enough. Your physician should be able to advise you, although he or she might suggest an exam or tests to ascertain the cause of the pain.
Don’t depend solely on medications to reduce your pain after surgery.
As compared to international surgical patients, U.S. surgical patients tend to use more pain medications after surgery, and yet they also report more pain. One study found that the use of morphine, an opioid pain medication, can actually significantly prolong the time that abdominal surgical patients experience pain.
This is not to say that medications shouldn’t be used to treat post-surgical pain. Medications certainly have their place. Rather, it means that other methods should be utilized in conjunction with medications.
For instance, at the University of Virginia Health Systems, many people who undergo abdominal surgery develop a painful condition called an ileus, commonly caused by too much intravenous (IV) fluid or opioid medication. To reduce the need for IV fluids, patients are allowed to have sports drinks up to two hours before their surgical procedures, as well as after surgery. Pain medications are still used, although opioid use is reduced. Patients are also required to spend a set amount of time out of bed and moving around in the days following surgery.
These combined changes in care have made a big difference. Patients are often able to be discharged two or three days sooner than usual, and they also report better control of pain after surgery.
If pain after surgery becomes chronic, there are still many treatment options.
Sometimes post-surgical pain persists beyond the time it takes for the surgical trauma to heal. One of the most common examples of this is failed back surgery syndrome. Mistakes during surgery, existing chronic pain, and poor patient selection can all contribute to the chronic pain associated with failed back surgery syndrome. In some cases, there is no discernable cause for the condition.
Options for chronic pain after surgery, such as that associated with failed back surgery syndrome, include:
- Oral pain medications
- Antidepressant medications
- Chiropractic care
- Physical therapy
- Transcutaneous electrical nervous stimulation (TENS)
- Nerve block injection
- Spinal cord stimulation
Have you experienced pain after surgery? How did you manage it?
Image by Army Medicine via Flickr