Pain After Surgery (cont.)
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
Pain After Surgery Causes
The cutting of the skin stimulates nerve fibers to signal pain. As the body begins to heal, pain should decrease and eventually stop. The amount of time pain lasts after surgery can depend on several factors such as the following:
- A person’s general health
- The presence of coexisting medical problems
- Cigarette smoking
On rare occasions, pain may remain, though the cause of pain cannot be identified. This condition can become long-term pain.
Pain after surgery can be a sign of surgical complications such as the following:
- Infection either in the skin or at another site in the body: Pain with fever (temperature higher than 100°F) or pain with redness, pus, or swelling at the surgical site is often a sign of infection.
- A break in the wound or separation of the wound edges prior to healing (called dehiscence): If the stitches or staples in the surgical wound are not holding the skin together, a dehiscence may be present.
- A collection of blood or other body fluid below the skin (a hematoma or a seroma): This collection of blood or fluid may cause pain and sometimes swelling at the wound site. This collection may have to be drained by a doctor.
- Vomiting or a change in your bowel habits after abdominal surgery: An obstruction in normal bowel functioning can occur following abdominal surgery and often causes pain and vomiting. Similarly, loss of intestinal movement (called ileus) may cause pain and vomiting. Both of these conditions need to be checked by a doctor.
- Formation of fistulas (abnormal passages between body structures): For example, a fistula may form between the bowel and the skin. Pain may be present with fistulas, but often only drainage from the surgical site, change in bowel habits, or weight loss may be present. Leaks occur when 2 pieces of bowel have been surgically connected and the connection fails. Bowel contents will leak out into the abdomen and may cause pain, vomiting, or fever.
- Lung complications: Especially after long surgeries or surgeries that require long recovery periods, a lung complication may occur. These complications may include pneumonia or a blood clot in the lung, called a pulmonary embolus, which may cause a cough, chest pain with breathing, fever, or shortness of breath.
- Chest pain: Have a doctor check any chest pain after surgery. People with prior heart problems are particularly at risk for heart attack (myocardial infarction) or partial blockage of the coronary blood vessels (unstable angina).
- Bleeding, either from the wound (external) or into the body (internal): Bleeding complications can range from minor problems to major life-threatening emergencies.
- Chronic conditions: If you have a chronic medical condition that causes pain, such as lupus or rheumatoid arthritis, you may find that surgery makes these conditions worse. Talk to the doctor before and after a surgical procedure to try to minimize the risk of making these conditions worse.
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