Treatment for chronic post-surgical pain

About 10 to 70 per cent of patients develop chronic post-surgical pain, depending on the type of surgery they undergo. In 2 to 10 per cent of patients, the pain is severe and disabling. Pain can diminish a person’s quality of life if it leads to depression, insomnia, emotional and mental stress, and functional impairments.

Doctors will usually first treat chronic post-surgical pain with a range of pain medications, including:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen (to reduce inflammation and control mild to moderate pain)
• Acetaminophen ( as a useful adjunct to reduce pain)
• Antidepressants (to reduce neuropathic pain, lower anxiety, improve sleep and mood)
• Anticonvulsants (to reduce neuropathic pain)
• Opioids such as tramadol (to lower pain intensity and manage moderate to severe pain)

Pain management may include psychotherapy and cognitive-behavioural therapy (CBT).

For specific pain conditions, doctors may recommend interventional pain procedures to reduce the pain.

How to prevent chronic post-surgical pain

You can minimise the risk of developing chronic post-operative pain by:

• Maintaining a state of calm before surgery

• Being overly anxious about the surgery may heighten your sensitivity to pain. Talk to your surgeon about your fears or concerns regarding the surgery.

• Managing your pain expectations

• Ask your surgeon about the nature and extent of post-surgical pain that may be associated with your surgery and how the pain will be managed.

• Being specific about the pain

• Tell your surgeon where the pain is located and how much it hurts, and whether you are suffering from unpleasant side effects such as nausea, vomiting and drowsiness from the pain medications.​

“A multi-disciplinary approach to pain management is best to improve the patient’s physical, emotional and social well-being,” says Dr Tan.

Ref: R14