What Causes Post Surgical Pain And Is It Treatable?

How To Understand & Successfully Treat Post-Surgical Pain

Are you one of the many individuals who have faced surgery only to find yourself grappling with significant pain long after the operation is over? If so, you’re not alone. The journey from surgery to recovery is often fraught with unexpected challenges, and for some, persistent postoperative pain can become a debilitating reality.

Most people who experience post-operative pain understandably assume that their pain is due to the fact that something went wrong with the surgery. This can be an extremely distressing experience, and the stress of this alone is the cause of untold suffering. Yet often the pain is caused by the bodies healing process halting, rather than a fault in the surgery.  And the good news is that many post-operative pains are very treatable with the correct rehabilitation and treatment. Many can even resolve with surprising ease after years of stubborn pain.

Also, perhaps even more surprisingly, research indicates there are ways of predicting who will experience persistent post-operative pain. While also offers clues as to the causes of post-operative pain.

Some Surprising Research On Post-Surgical Pain

Surprisingly there was a way to predict your likelihood of experiencing prolonged pain before you even go under the knife? A recent study conducted at Christchurch Women’s Hospital here in New Zealand suggests that a simple test may hold the key to identifying individuals at higher risk for ongoing postoperative pain.

The cold pressor test (CPT) is a procedure that involves immersing your hand in icy water for a short period of time. During the test, researchers measure two key factors: pain threshold (when it takes to start feeling pain) and pain tolerance (how long you can withstand the discomfort before withdrawing your hand). So essentially, it measures a person’s basic level of pain sensitivity and pain tolerance.

In a recent study, researchers recruited 54 patients undergoing gynaecological surgery and administered the cold pressor test before their operations. They found that individuals who had a lower pain threshold in the test were more likely to experience prolonged pain after surgery. So those of us whose body generates pain more readily are more likely to get post-surgical pain. These findings may have significant implications for both patients and healthcare providers. By identifying individuals at higher risk of severe post-surgical pain, in the future, clinicians may be able to tailor their treatment plans to provide more targeted pain management strategies. This could lead to better patient outcomes.

Understanding Diminished Pain Tolerance

There is little doubt that genetics play some part in determining our basic level of pain tolerance. In turn, genes also influence the likelihood of getting persistent pain after surgery. Yet genes are definitely not the only factor known to determine how pain-tolerant we are.

One very significant factor in determining how pre-disposed to pain a person is can be emotional trauma or ‘adverse life experiences’. In the clinic, we see a great many people with post-surgical severe pain who also happen to have had more than their fair share of emotional trauma.  And a greater instance of post-surgical pain in those who underwent surgery during a stressful period in their life. And this most certainly is not likely to be a coincidence. The adverse experiences we go through in life can profoundly affect how we process pain. Significant trauma tends to make us more prone to chronic physical pain, surgical or otherwise.

Many of the people who suffer the worst pain after surgery report that they were going through a very stressful period at the time of the surgery. Others may not have been stressed at the time of the surgery but were carrying stress from past traumas that they had not managed to fully process. These past and present stressors can play a key role in how well the body recovers from surgery, which is a fundamentally traumatic event in itself.

For a moment consider that surgery is a major stressor. And that we need resilience to make a good recovery from surgery. Then consider the broad concept of resilience as it applies to someone with PTSD after military service. Individuals with PTSD often find that they have extremely low levels of resilience to stress. For some, even a simple, loud noise in their environment can send them into deep states of trauma known as flashbacks. PTSD sufferers are also notoriously prone to chronic pain and poor treatment outcomes. In some way, reflecting on this may assist you in understanding the possibility that your post-surgical pain may represent a loss of resilience caused by significant prior events in your life. Were you in a physically and emotionally robust place when you were operated upon? Many of us obviously were not.

But what if you have severe persistent pain after surgery but you don’t have a bunch of unresolved stress and trauma?

What About The Physical Side Of Persistent Pain After Surgery?

With all this talk of the influence of stress and trauma, it’s important to point out that some stubborn post-surgical pains are far more ‘physical’ in nature. And not caused by the stress or trauma of the mental and emotional variety. In my experience, most of these are caused by scar tissue and chronic inflammation at the surgical site. If your instinct about your post-surgical pain is that it doesn’t relate to stress or trauma, you may have unresolved scar tissue or unresolved inflammation at the surgical site.

One of the interesting (and kind of annoying) things about living in the human body is that it doesn’t always heal they way we would like it to. While most of our injuries resolve pretty nicely, a small portion of them always seems to be that don’t heal up the way they might have done for many others.

My guess is that modern humans don’t heal as well as many of our hunter-gatherer ancestors did. If this is true, it is most likely due partly to a lack of movement. Our ancestors had to hunt down and process their own food, find and carry their own water, build their own shelters, move around entirely on foot, carry their children everywhere and occasionally fight off or flee from large predators. Meanwhile, our primary mode of being is the sitting position, both in our work lives and increasingly in our social and home lives. The average person now may only engage in 5% of the movement our ancestors did on a day-to-day basis. This is a recipe for poor healing. Scar tissue must be stretched and kneaded to develop full elasticity as it forms. This stretching and kneading is badly lacking in someone who is forced to sit at a desk for most of their waking life.

So it’s probable that many post-surgical pains are caused by very tight scar tissue that didn’t heal optimally due to a sedentary lifestyle. This is further exacerbated by medicines’ ongoing lack of attention to diligent post-operative movement prescription and rehabilitation. The physiotherapy offered at hospitals is seldom much better than the food offered at hospitals, they are both still all too often an afterthought.

In any case, understanding that your post-surgical pain could be caused by unresolved inflammation or scar tissue that didn’t form in a healthy way can be a game changer. Effective treatment approaches for chronic scar tissue and inflammation do exist.

Treatments For Stubborn Pain After Surgery

If you have the type of post-surgical pain that is caused by poor scar tissue healing and/or persistent inflammation at the surgical sight you will need some assistance with tissue healing. The treatments that work best for this type of pain are those that ‘wake up’ the body’s healing processes, increase blood flow and increase tissue mobility both in and outside of cells.

Radial Shockwave Therapy was developed in the 1980’s to break up kidney stones

Looking Ahead

While the results of this study are promising, further research is needed to fully understand the clinical significance of the cold pressor test in predicting postoperative pain. Larger studies involving diverse patient populations will help validate these findings and determine how they can be integrated into routine clinical practice.

In the meantime, if you’re facing surgery in the future, don’t hesitate to discuss pain management options with your healthcare provider. By staying informed and proactive, you can take steps to optimize your recovery and minimize the risk of prolonged postoperative pain.