I had surgery. Why am I still in pain?

Few things are as frustrating as this.

When you do all the right things, go through all the proper steps, and you still can’t achieve the desired result… where do you turn?

In the case of post-surgery pain, a mental strain gets added to the physical one.

Read on to learn why pain sometimes continues on after surgery — and the treatment options available when it does.

Is pain after surgery normal?

Yes, some level of pain following a procedure is expected. Of course, that pain should lessen over time, gradually improving and becoming less intense until you’ve reached the desired level of comfort.

In some cases – roughly 10% of patients – the pain can persist for an extended period of time, beyond the regular healing window. Almost as if the surgery never happened. Now you’re back to Square One, with an injury that interferes with your daily life.

As frustrating as post-surgery pain can be, it’s not necessarily a sign that your surgery was a failure.

Why you’re still in pain after surgery

While it’s not ideal, there is some level of normalcy to extended post-surgery pain. When it does happen, there are a few common reasons for it.

Chronic inflammation. Following a surgery, your body endures a highly coordinated healing process. When the tissues remain inflamed longer than the expected recovery time, the cycle fails to “shut off” and the pain remains.

Nerve irritation. A burning or shooting sensation that lingers longer than normal may be due to nerve characteristic changes in surgery. The nerves may have become abnormally stretched or compressed or even hypersensitized during the procedure.

Scar tissue formation. Following a surgery, your body responds with a natural healing process that includes forming key scar tissue. If that goes awry and the new tissue forms where it shouldn’t – around nerve roots – it can become an irritant.

Central sensitization. The nervous system is put under a lot of stress during long periods of pain. Sometimes following surgery, even after proper healing, the nerves remain stuck in a perceived sense of pain – they’re actually misinterpreting regular signals as pain signals.

When should you seek medical attention?

These are the red flags to watch for in the weeks and months following a surgical operation.

🚩Your pain isn’t getting better – it’s getting worse.

🚩Your problem area is becoming weaker rather than stronger.

🚩The numbness that was restricted to one area of your body is spreading.

🚩The target pain area seems to be infected or getting infected.

🚩Your pain is affecting your routine daily activities and ability to sleep, even months later.

The steps to take to address post-surgery pain

Step 1: Reassessment

Visit a professional and have them review your medical history, take imaging, and conduct a physical exam. Take a full overview of where your body is at.

Step 2: Physical therapy

Even after surgery, we always go back to conservative treatment first. Try building strength, increasing mobility, and restoring movement in the affected limbs and muscles.

Step 3: Medication

If pain persists through physical therapy, it’s time to try treating the pain internally. Seek a prescription for anti-inflammatory or neuropathic pain medication.

Step 4: Intervention

Now we can get a little more aggressive. Epidural steroid injections are designed to help reduce inflammation and relieve pain. Nerve blocks and joint injections aim to identify a specific pain source. Radiofrequency ablation uses electrical current and heat to selectively destroy troublesome tissue.

Step 5: Spinal cord stimulation

When all of the above have failed, we consider SCS, a medical implant that shoots mild electrical signals to alter pain signals on their way to the brain. To learn more about this option, see our deep dive on spinal cord stimulation for failed back surgery.

One thing to remember

Post-surgery pain does not equal a failed procedure.

Pain can persist long after tissues have healed in roughly 10% of cases. The most likely causes are ongoing inflammation, nerve irritation, scar tissue, or nervous system changes.

The good news is, a range of treatment options — from conservative to intensive — are available to help patients regain function and improve quality of life.

How Hudson Pain and Spine can help

Folks in the Englewood, New Jersey area that are experiencing chronic post-surgery pain should contact Hudson Pain and Spine. Dr. Saurabh Dang, a double board-certified pain management specialist and an expert in post-surgery pain. He can help determine the best care plan for you.

If your pain lasts more than two weeks, includes radiating pain, numbness, tingling, or weakness, and limits your ability to work, sleep, or do normal activities, contact Hudson Pain and Spine to schedule a consultation.

Hudson Pain and Spine 25 Rockwood Place, Suite 335, Englewood, NJ 07631 Phone: (201) 605-9000