Pain Management After Surgery

Authored by Shelley Ivory.

Commonly following any operation regardless of the extent of the work there is an inflammatory response. This may be a response to the incision site or tissues that have been moved or cut in the process of the surgery.

Inflammation is an important part of the healing process, however, it can cause many unfortunate side effects. Pain and alterations in muscle recruitment are two of these.

Pain is the body’s interpretation of signals sent from an area. With inflammation, there are increases in chemical and pressure signals. Minimising these signals without removing them entirely will often help reduce pain levels, while not interrupting the healing process. This consequently improves the recruitment of postural muscles while decreasing compensatory strategies.

Like asking a sprinter to run a marathon, these compensatory strategies often fatigue much quicker than the normal postural/ control muscles. As muscles fatigue, they can also become a source of pain. For example, if I asked you to lift your arm up straight in front of your body and hold it. For a certain length of time, your muscles are very happy with this task but after a few minutes, you may start to feel an ache in your neck or shoulder as a result of the muscles fatiguing.
A very simple way to minimise this post-operative effect of swelling, with minimal side effects, is icing!

Icing is a very commonly overlooked option for both pain reduction and swelling management post-operatively, regardless of the site. Swelling also persists to some degree for weeks to months following surgery meaning ice may be used for pain relief for a very long time following surgery.

Usually, we will advise someone to apply ice to an area for 10-15mins. If it is also possible to provide compression to the area and elevation (until the affected area is higher than the heart) at the same time, this is also of benefit. After the 10-15mins, remove the ice and wait for the area to return to normal temperature before reapplying. Always ensure there is a layer of material directly between your skin and the ice, and be extra careful if you have any medical conditions which mean you have decreased sensation in that area to best protect the skin. This may be repeated multiple times in a row or throughout the day. Usually in the earlier days post-operatively this should be more frequent and then as the weeks are going on, apply ice following exercise or increased activity levels for pain relief.

Range of movement exercises, as well as gentle and moderated return to activity levels, may also help to modulate the inflammatory response and some of its negative side effects. If you require further information regarding your specific operation please seek advice from your local Physiotherapist or medical professional.

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