Pain persisting after surgery
Pain Knowledge 3 aims to help you understand why pain persists after surgery.
Pain persisting after surgery (or persistent post-surgical pain PPSP) refers to someone who is experiencing daily pain that occurs in the same area of their body where the surgery took place or pain that is referred from the site of their surgery.
After back surgery, you might experience ongoing pain in your back, buttocks or in your lower limbs.
Persistent refers to pain lasting for longer than 3 months after surgery, which is the time that the tissues that were operated on are expected to have fully healed from the surgery.
For some people, the impact the pain has can range from being mild, with little interference in activities or enjoyment of life to severe with significant life changing interference in activities, reduced mood, sleep and quality of life.
It is critical that your surgeon has excluded surgical causes of persistent pain such as infection, a fracture (broken bone) or hardware failure (such as a loosened or damaged screw or plate).
This is usually done with blood tests and radiological investigations (e.g. x-rays, CT scans). It is important to hear that your surgeon believes that there is ‘nothing wrong’ with the area that was operated on or words to that effect.
Watch out for new areas of the spine (“above or below” the operated area) getting blamed for the persisting pain after surgery as this often leads to recommendations for further surgery (revision or extension or fusion).
As you explore further in this chapter, you will understand that blaming pain on body parts does not explain why pain persists after surgery.
There are few studies showing outcomes for people with pain after multiple back surgeries, but in the studies that do exist, with each further surgery, there is less reduction in pain.
This level explores why pain occurs and how to treat it:
Is it only me? explores the incidence of persistent pain
Risk factors discusses contributors to why some people develop persistent pain
Why does pain persist? provides a rational explanation
Maria still has back pain is a quiz that helps you to reframe your pain and use your knowledge to beat it
