Post-Surgical Chronic Pain is pain that has developed after a surgical procedure and lasts for at least 3 months. It is one of the most frequent complications after surgery, with an important negative impact on patients' quality of life that constitutes significant economic and healthcare burdens. Obesity, inflammatory diseases and increased life expectancy have resulted in an increasing volume of surgeries such as hip and knee arthroplasty that are associated with a high risk of Post-Surgical Chronic Pain.
Post-Surgical Chronic Pain frequently has a neuropathic component to it namely: spontaneous sharp, stabbing pain, increased sensitivity over the skin. There may also be sensory loss over the surgical incision.Associated symptoms include:
It can’t be predicted who will develop chronic pain after operation, but some risk factors have been identified. These include preoperative pain, the type of surgery (with higher risk for thoracotomy, mastectomy, amputation, hernia repair, and coronary artery bypass surgery), degree of postoperative pain, anxiety and depression.
Several clinical reports emphasize nerve damage during surgery as one of the main factors of chronic postoperative pain. Central nervous system changes contribute to the development of persistent pain following surgical trauma and nerve injury.Phantom Limb Pain
Phantom limb pain feels like it’s coming from a body part that’s no longer there. This type of pain occurs mostly in people whose arm or leg has been amputated. The disorder may also occur after surgeries to remove other body parts, such as the breast, penis, eye or tongue. It ranges from mild to severe and can last for seconds, hours, days or longer. If one of the limbs is amputated, it feels like the limb is still there. This is called phantom sensation. Phantom sensation may feel like:
Phantom limb pain feels as if the pain comes from a body part that no longer remains.
Characteristics of phantom limb pain include:
An important factor that increases the risk of phantom pain is pain in the area before amputation. Approximately 60%–80% of amputees experience phantom limb sensations. An estimated 8 out of 10 people who lose a limb experience some degree of phantom pain.
The exact cause of phantom limb pain is not clear, but it appears to originate in the spinal cord and brain. There are number of other factors believed to contribute to phantom limb pain, including damaged nerve endings, scar tissue at the site of the amputation and the physical memory of pre-amputation pain in the affected area. A few possible reasons are widely believed: