Pain that is severe and persistent, with no apparent cause other than a previous trauma occurred that had already healed, is categorized as “post-traumatic pain”.
Physical bodily trauma can occur after a surgery or deep tissue injury which results in blunt force trauma and causes a concussion, cut, and/or fracture. After a “traumatic” event, experiencing pain is common as physical trauma or injury can result in significant damage to affected tissues and bones. Pain from a traumatic event is initially considered acute, although if pain persists for several months it would then be classified as “chronic”. As long as the body is healing from its injuries, pain is common and can range from mild to severe depending on various factors.
In some cases, even after the patient’s injuries have completely healed and no physical evidence of the trauma remains, pain continues to be experienced by the patient.
The medical community defines any pain that persists past the normal healing time (3 to 6 months) as chronic, persistent, or post-traumatic pain, often requiring a multi-modal approach to pain management and treatment. A significant percentage of individuals who experience some type of physical trauma may also suffer from post-traumatic pain because of a heightened response and sensitivity of their nervous system caused by the trauma.
What are the causes of post-traumatic pain?
Post-traumatic pain (or “trauma pain”) is often used interchangeably with conditions such as complex regional pain syndrome (CRPS), causalgia, and/or reflex sympathetic dystrophy syndrome (RSD) because the reason why post-traumatic pain occurs is not always clear and can be difficult to accurately diagnose.
That said, it is believed that post-traumatic pain usually occurs because of faulty communication between the central and peripheral nervous systems caused by nerve damage (called causalgia or mimocausalgia), which leads to pain, inflammation, or numbness in a patient. In these cases of trauma pain, the nerves in the region where the initial trauma was experienced become extra sensitive, although the extent of a traumatic event is not a direct indicator of the intensity of the pain being experienced.
What are the risk factors associated with post-traumatic pain?
Despite the variability of traumatic events (and the damage and pain they cause), there are common risk factors associated with this condition, such as:
- Intensity of pain experienced during the traumatic event(s)
- Duration of intensive care and hospitalization
- Being 65 years of age or older
- Anxiety or stress related to the injury/surgery
- Quality of care post the traumatic event
- Intensity of traumatic event(s)
- History of alcohol or substance use
- History of anxiety, depression, or PTSD
What are the signs and symptoms of post-traumatic pain?
After any physical trauma, the signs and symptoms of post-traumatic pain involve mild to severe pain and discomfort, and are often expressed differently in people. Even after the injury heals, individuals often experience the pain and correlating symptoms in different ways.
Some of the most common symptoms of post-traumatic pain include:
- Changes in skin temperature (ranging from hot and sweaty to cold)
- Changes in skin color (from white to red or blue)
- Changes in growth of nails and hair
- Hypersensitivity to touch and cold
- Changes in skin texture
- Burning sensations
- Tingling sensations
- Throbbing pain
What are the complications that can arise due to post-traumatic pain?
In many cases, the pain and symptoms associated with a traumatic event will either resolve on their own completely or will have very minimal health implications for an individual in the future. In other cases, pain may last for several weeks or months and require a proper post-traumatic pain management plan.
When trauma pain is not diagnosed and treated early on, it can rapidly lead to additional symptoms. Complications that can arise due to post-traumatic pain include:
- Tissue wasting or atrophy where the muscles, bones, and skin or a specific region may weaken and deteriorate due to lack of use
- Muscle tightening or contracture where the limbs can get set into a fixed position
- Physical morbidities such as hypertension, obesity, and musculoskeletal pain
- Decreased movement and functionality in the affected region
- Depression and anxiety
When should I see a doctor for post-traumatic pain?
Whether you are experiencing a headache (possible post-traumatic headaches), feeling pain in the joints (possible post-traumatic arthritis) or are experiencing any of the signs and symptoms listed above, you should consult with your physician immediately. Post-traumatic pain is often misdiagnosed, so an accurate evaluation and timely diagnosis become an important first step towards post-traumatic pain management.
Schedule a same or next day appointment at Advanced Pain Care for an immediate evaluation of your condition.
How is post-traumatic pain diagnosed?
Different types of trauma can affect different type of nerves in the human body which results in post-traumatic pain. There is no specific standard or test to diagnose post-traumatic pain, although pain management specialists at Advanced Pain Care approach evaluations and diagnosis on a case-specific basis through evaluations of different factors including symptoms, severity, and duration of a patient’s trauma pain.
Here are the first steps physicians take to determine if the pain should be classified as post-traumatic pain:
- Physical examination and evaluation of the symptoms
- Past medical history (physiological and psychological)
As there is no one specific test that can help narrow down the diagnosis, physicians use the following tests to detect changes in the body:
- Erythrocyte sedimentation rate (ESR) (to isolate symptoms that could indicate other diseases)
- Sympathetic nervous system tests (to detect disturbances in the sympathetic nervous system)
- Peripheral nerve blocks (to isolate the triggers of the pain caused by specific nerves)
- Magnetic resonance imaging (MRI) (to detect changes in tissues)
- Bone scans (to determine changes in the bones)
- X-rays (to detect changes in the bones)
Your physician may also advise other case-appropriate tests and examinations to determine possible treatment options.
How is post-traumatic pain treated?
Post-traumatic pain management and treatment at Advanced Pain Care involves a multi-specialty approach to treatment. Common treatments for trauma pain include:
- Analgesics and pain relievers (such as aspirin and ibuprofen)
- Antidepressants and anticonvulsants
- Corticosteroids (to reduce inflammation)
- Spinal cord stimulation (to relieve post-traumatic pain)
- Sympathetic nerve-blocking medication (to block pain signals)
- Local anesthetic injections (such as lidocaine)
- Physical Therapy
Is surgery required to treat post-traumatic pain?
Surgical intervention to relieve chronic pain associated with post-traumatic pain is usually the last step in post-traumatic pain management options. The need for surgery, while rare, may occur in specific cases, such as post-traumatic arthritis. In extreme cases of trauma pain, pain management specialists may consider surgery (such as a sympathectomy). Speak to your pain management specialists at Advanced Pain Care to get a clear understanding of your condition and treatment options available.
What precautions can I take to prevent post-traumatic pain?
The most common steps to prevent (or treat) post-traumatic pain include:
Q: What does post-traumatic pain mean?
A: Post-traumatic pain (or “trauma pain) is categorized as physical pain that is severe and persistent, occurring after a person experiences a traumatic event (injury, surgery, etc.), and persists past the normal healing time (3 to 6 months). Trauma pain often resolves itself on its own, although when post-traumatic pain develops into a chronic condition it often requires a multi-specialty approach to pain management and treatment.
Q: Can post-traumatic arthritis go away?
A: Post-traumatic arthritis is a type of arthritis that can occurs after a traumatic injury to a joint. This specific type of arthritis usually goes away automatically after 2 or 3 months, although if pain and symptoms persist beyond 6 months, medical treatment becomes very important. In some cases, the onset of symptoms may not occur until several years after the traumatic event, with various treatment options available include analgesia, physiotherapy, and in rare cases, surgery.
Q: How can you ease post-traumatic pain?
A: Depending on the symptoms and levels of pain being experienced by a patient, post-traumatic pain can be relieved using the following options:
- Pain relievers
- Anticonvulsants and antidepressants
- Physical therapy
- Spinal cord stimulation
- Sympathetic nerve-blocking medication
- Transcutaneous electrical nerve stimulation (or “TENS”)