Chronic postoperative pain, however, persists after the expected healing time from surgery. It is more common than you might think. In fact, it is estimated that between ten and 50 percent of people who have surgery experience chronic postoperative pain.
The cause of chronic postoperative pain, also known as chronic post surgical pain or CPSP, is not completely understood. However, most researchers agree on a few potential causes:
- Peripheral nerve damage during surgery
- Inflammation at the site of the wound
- Damage to bodily tissues during surgery
- Prior history of chronic pain disorders
- A history of anxiety and/or depression
- Excessive fear of the surgery
- Pre-operative pain
- Extensive (lasting more than three hours) or complicated surgeries
You can experience chronic postoperative pain from almost any type of surgery, including outpatient procedures. Examples of postoperative pain include:
- Phantom limb pain
- Post-mastectomy pain
- Pain following hernia repair
- Postoperative pelvic pain
- Postoperative back pain
Chronic postoperative pain can be treated with any of the following:
- NSAIDs. Anti-inflammatories such as ibuprofen and aspirin may be used to control mild to moderate postoperative pain. They may be used to treat severe pain as well, in combination with other painkillers.
- Acetaminophen. Acetaminophen is another option in treating mild, moderate or severe postoperative pain. It may be used alone or in conjunction with other painkillers.
- Opioids. Weaker opioids may be used to treat moderate postoperative pain, while stronger ones may be utilized for more severe cases.
- Anticonvulsants. Anticonvulsants may be used to manage certain types of postoperative pain, especially those associated with nerve damage.
- Nerve blocks. In some cases of severe postoperative pain, nerve blocks may be used to reduce pain sensations.
Chronic postoperative pain treatment is often multimodal – this means that treatments are often combined to provide maximal pain relief. If you have chronic postoperative pain, it's likely you are (or will be) taking more than one type of painkiller.
Coping with chronic postoperative pain is not easy. Many people may feel that something in their surgery “went wrong.” However, with certain types of surgery, nerve and tissue damage are difficult to avoid. If you have chronic postoperative pain, you may feel surprised that surgery did not take your pain away. This can lead to feelings of hopelessness, anger or even depression.
Coping with any type of chronic pain is difficult. However, there are a few things you can do to help.
- Keep a pain journal. Use your pain journal to record pain patterns as well as how your pain makes you feel. You can use this to help your doctor find the right treatment. You can also use it to vent your feelings about your pain.
- Learn to relax. The stress response can increase both pain sensations and pain intensity. Taking the time to relax can help you decrease this pain response and allow you to focus on other things.
- Distract yourself. No, your pain is not all in your head. However, you are still in control. Focusing on your pain alone can make the sensations seem more intense. Instead, try to focus your mind elsewhere. Read a book or watch some television.
- Find support. Talk to someone who is willing to listen, or who knows what you are going through. Share ideas and coping strategies, or simply vent your feelings.
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Lake, Alfred Philips. Chronic Post-Surgical Pain: Prevention Remains Better Than Cure. The Internet Journal of Anesthesiology 2008 : Volume 15 Number 2
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