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Types of Post-Surgical Pain and How To Manage Each

By Matthew Hellman, M.D.

Post-surgical pain is pretty common and has a number of possible causes, including tissue damage. Tissue damage can happen at the point of incision, during the procedure itself, or at the closing of the wound. 

You may also experience other forms of pain like muscle and joint pain in the nearby extremities that results due to a loss in mobility or overworking, due to surgery in a central area of your body that is either making you not able to move those other extremities or rely more heavily on them. For example, if you had back surgery and you are bedridden or restricted to a walker or a wheelchair, you may experience pain in the neck or in your legs, given your access to mobility in your back has changed. 

Treatment options for each type of pain are really going to address the type of pain you are experiencing and the symptoms associated with it. If you are experiencing any type of pain that prolongs, increases, or simply becomes unbearable, it is vital to contact your surgeon or pain doctor to hopefully tackle it sooner rather than later. 

Types of post-surgical pain

Neuropathic Pain

Post-surgical pain caused by damage to the nerve cells is called neuropathic pain. This pain occurs when damaged nerve fibers send the wrong signals to the pain receptors.

 You can experience neuropathic pain in two ways. You could feel a sudden sharp, shooting, electrical, tingling,  hot/cold, burning sensation in the area or feel pain as a result of contact with stimuli. The stimuli can be as simple as touching that part of the body against something innocuous, like brushing up against the wall. You may also experience trouble sleeping as a result of the pain. 

There are two types of neuropathic pain. Central neuropathic pain is from damage to your brain or spinal cord. This usually occurs during brain, head, or spinal surgery. The other is peripheral neuropathic pain which can occur in nerves that are not a part of the brain or spinal cord. Usually, a person may experience this pain when they are getting a joint replacement and repair. 

The damage from neuropathic pain can be quite serious and can actually result in more surgery. For example: if you get neuropathic pain in your arms and legs as a result of surgery, you may have to get a second surgery to replace or repair the joints in that area to stop feeling the pain. 

You may also feel some relief from non-steroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen. It also may be worth receiving regular massages and acupuncture to support your pain. Your doctor may also prescribe Gabapentin or Lyrica to you. 

Somatic Pain

Somatic pain is pain centralized in a particular area of the body. There are two types of somatic pain: deep and superficial. Both entirely depend on how deep the wound or pain is to the exterior of the body. 

Superficial somatic pain is probably the quickest of the two to heal. It can surface as cuts, bruises, burns, or skin wounds around the incision area. It tends to go away over some time of healing. But if you would like to support the healing process, you can use over-the-counter NSAIDs medications that can relieve the pain and have anti-inflammatory properties, respectively.  

Deep somatic pain affects the tendons, ligaments, joints, bones, and muscles. It can manifest itself as a dull or achy feeling in those areas and can spread to other parts of the body outside the operated area. If your surgeon has to cut through a muscle to reach some area of your body during surgery, you will likely have deep somatic pain as a result. 

The treatment for deep somatic pain is going to be pretty similar to superficial somatic pain. However, your doctor may be able to prescribe muscle relaxers and a short course of opioid medication to support your pain management right after the surgery. It is important to be cognizant of how you take this medication because opioids are highly addictive. 

Visceral Pain

You may experience some pain in your major organs that results in vomiting, cramps, inflammation, overactive or underactive bowel and bladder function, or heart racing. It may occur due to the stress of the surgery on the body and the mind. It is harder to pinpoint this kind of pain because this pain can occur outside of surgery as well. But, if you see any changes in your body after surgery, it is best to address those changes with a doctor. 

You may be prescribed certain medications to relieve your symptoms, or you can always take over-the-counter drugs that can treat some of your symptoms. Depending on what type of pain it is, you may be able to support your pain through a change in lifestyle, such as adopting a nutritious diet and regular exercise. Small changes may make a big difference in your pain management after surgery.

Post-surgical pain persisting past the timeline of your surgery is normal. However, if your pain is consistent and doesn’t get better, it may be time to see a pain doctor to support you in your particular case. The doctor should be able to work with you so that you can better understand your treatment options and create a plan that works best for you. 

Dr. Matthew Hellman

Dr. Matthew Hellman is a double board-certified, Harvard-trained interventional pain management physician and anesthesiologist. He was born in Northern Virginia and he attended Duke University where he obtained a bachelor’s degree in science and engineering while studying biomedical engineering. View Profile