Persistent pain can affect half having major surgery: Global Year Against Pain After Surgery

January 24, 2017

The Global Year Against Pain After Surgery, which launches today, draws attention to the millions of people worldwide affected by persistent or chronic pain as a result of surgery—many of whom fail to get appropriate treatment.

The problem is not limited to major surgery, as even minor operations such as a hernia or Caesarean-section can lead to ongoing pain. 

The International Association for the Study of Pain (IASP) reports persistent post-surgical pain can affect as many as one in two patients undergoing major surgery such as amputations, and one in four for all kinds of surgery combined.

Most persistent post-surgical pain is the result of nerve damage, and can be due to the original medical problem or the surgery itself. It is identified by symptoms of neuropathic pain such as burning pain, shooting pain, numbness and changes to physical sensation or sensitivity to temperature or touch.

Professor Stephan Schug, one of Australia’s experts on the management of post-surgical pain, says many health professionals are still unaware of the problem.

“In the past, we under-estimated how many people developed chronic pain after surgery and it is still poorly understood,” he said.

“It is critical that doctors are well versed on the matter, because there are ways to reduce the risk.”

There is a strong link between the severity of pain in the 10 days or so after surgery and the development of long-term pain. This means adequate pain relief immediately after surgery is critical to preventing ongoing pain.

Other risk factors for onset of post-surgical pain are pre-existing pain, dependence on opioid medication, anxiety, infection and bleeding, and chemotherapy.

However, most patients are unaware of the risks.

Forty-four-year-old Melbourne mother-of-two Victoria Moro wasn’t told about the risk of nerve damage when a skin graft was taken from her arm eight months ago.

“I had a wound on my foot from an injury that wouldn’t close, so they took a skin graft from my arm. Ever since, I’ve had shooting or stabbing pain down my arm and into my hand, and altered sensations and numbness through my wrist and into my palm and thumb,” said Victoria.

Her 19-year-old son has stepped in as her driver and her carer as she is currently unable to drive and is working just eight hours per week.

For 47 year-old Susanne Dancer, who lives in Brisbane, an operation to remove a skin cancer on her forehead prolonged her life but caused devastating ongoing pain.

“My forehead is numb and I have pain radiating to the middle of my head, which causes feelings of nausea. It means I can no longer work or drive, and I’m reliant on my husband a lot. I try to stay upbeat, but it can be depressing,” she said.

“I was told there would be nerve damage, but I was never told about the pain.”

CEO of Painaustralia Lesley Brydon says these stories are far too common, and patients need better advice before surgery.

“Despite the prevalence of post-surgical pain, it is worrying that most people are ill-informed about the risk and unprepared for how to live with the pain, should it happen to them,” she said.

Forty-three year-old Sydney psychologist Rachael Miles has been living with post-surgical pain for the past seven years, and sees herself as part of the solution.

“I had surgery in my cervical spine after a car accident and was told there was a five percent chance of becoming a paraplegic, but I was never told about the risk of ongoing pain,” said Rachael.

“Each day I have burning pain in my neck, which radiates down my arms and into my fingers, into my head and sometimes onto my face. It feels like someone has just poured boiling water on me.

“Fortunately my background in meditation and my profession as a psychologist have given me the tools to deal with the pain. It’s become a mission for me now, to help others with chronic pain.”

Painaustralia is calling on the Federal Government to implement the recommendations of the National Pain Strategy to improve prevention and management of pain for all Australians.

The IASP Global Year Against Pain After Surgery aims to promote better pain management through education and increased awareness.

Helpful websites:
What the public should know about pain after surgery
IASP Fact sheets on pain after surgery
Acute Pain Management: scientific evidence, 4th edition, 2015

Professor Stephan Schug, Lesley Brydon and patients are available for interview upon request.
Media contacts:
Lesley Brydon, Painaustralia CEO
0413 990 991 

Issued jointly by the Faculty of Pain Medicine, Painaustralia and the Australian Pain Society. 

Copyright © Australian and New Zealand College of Anaesthetists.