How to Cope With Chronic Postoperative Pain

Most of us would expect to have some degree of pain after undergoing surgery. However, when the pain persists beyond what would be considered normal, that is an entirely different—albeit relatively common—situation known as chronic postoperative pain.

All told, between 10 percent and 60 percent of people who undergo surgery will experience this. Fortunately, it is a condition that can usually be managed and, in most cases, one that will resolve on its own.

Causes of Chronic Postoperative Pain

It is often difficult to pin down a single cause of chronic postoperative pain. In many cases, post-surgical complications (including nerve damage, tissue damage, scar tissue formation, and infection) may be exacerbated by pre-existing health factors which predispose a person to pain.

These may include:

• A prior history of chronic pain disorders, such as fibromyalgia
• Pre-existing nerve pain, such as peripheral neuropathy
• Certain autoimmune diseases, such as rheumatoid arthritis, in which surgery may cause a flare-up of pain symptoms
• Older age, in which a person tends to heal more slowly
• A history of anxiety or depression (as there is a direct interrelationship between psychological distress and chronic and acute pain)

Furthermore, complicated surgeries or ones lasting for more than three hours are more likely to result in chronic postoperative pain. The same applies to certain types of adjunctive therapy used to support surgery, including chemo and radiation therapy used after cancer surgery or radioiodine therapy used after a thyroidectomy.

Treating Chronic Postoperative Pain

For persons with chronic postoperative pain, the treatment approach is based on two things: managing the pain with drugs and other medical interventions and treating any associated health conditions. For this, a multifaceted approach is needed to ensure sustained relief.

Common pharmaceutical interventions include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) or Tylenol (acetaminophen) to treat mild to moderate pain
• Opioid drugs to treat moderate to severe pain
• Anticonvulsants to help treat certain types of postoperative nerve pain (neuralgia)
• Nerve blocks if the neuralgia is severe

Certain types of surgery (particularly those involving the back, neck, or joints) will require a structured program of physical therapy and rehabilitation to support healing.

If there are psychological factors complicating the pain, it is important to address these, as well. Options may include psychotherapy and/or medications to treat an underlying depression or anxiety. Pain medications alone are usually less effective if a person's emotional health is not adequately addressed.

Coping With Chronic Postoperative Pain

Coping with chronic postoperative pain is not an easy thing to do. The resulting stress only adds the burden, leaving the person to wonder if this is a permanent condition they will have to learn to live with. In most cases, it won't be, but that doesn't necessarily make things easier in the here and now.

If faced with chronic postoperative pain, there are several things you do can to better cope as you work with your healthcare provider toward a solution. These include:

• Keeping a pain journal to record pain patterns and help you and your healthcare provider better understand the primary and underlying causes of the pain
• Learning to relax to alleviate stress that can complicate your condition
• Using targeted meditation to identify and actively release reactive body tension
• Finding support to reduce isolation, share your feelings, and get help with activities and chores while you recuperate