Monday, March 21, 2011

Pain and Scarring Following Surgery

With surgery comes pain - a basic medical fact. Every surgery involves an incision, a surgical cut into body tissue or an organ. The site of the incision is called a wound, whether on the surface or deep inside the body. A surgical incision is an assault on the body. Cutting tissue and nerve endings traumatizes, or shocks, them. This causes pain.

Surgical Pain

Pain, and a person's reaction to it, is highly individualized. The amount and intensity of surgical pain depends on your overall fitness and health, your tolerance for pain, and the operation you have. Certain major operations - such as Caesarean section and traditional open hysterectomy - that involve large surface incisions and procedures deep in the body result in more surgical pain than some minor operations do.

Fortunately, for an operation, you receive an anesthetic. An anaesthetic is a medicine that slows down some of your body's systems and prevents you from feeling pain during your operation.

Unfortunately, the anaesthetic wears off. You feel pain and discomfort after your operation. This pain is known as surgery pain, surgical pain, or post-surgical pain. The pain is a kind of post-traumatic stress to the spinal cord, the part of the central nervous system that carries pain messages to the brain.

Adhesions and Scars

Post-surgical pain is usually caused by scarring, also known as adhesion formation. Post-surgical adhesions and scars are a natural and necessary part of recovery. Adhesions begin to form almost immediately after tissue is cut and make up the first step in the healing process. When body tissue is cut, tiny strands of a protein called collagen rush in to repair the damage. Collagen is a glue-like substance that binds, or reconnects, damaged tissue. It works on tissue both on the surface and deep inside the body. The microscopic but strong collagen fibers begin the process of post-surgical adhesion formation, creating scars that last a lifetime.

Post-surgical adhesions and scars cause pain when the tissue begins to shrink and the adhesions restrict nearby tissue or internal body structures designed to move independently. This can create a painful cramping or pulling sensation inside the body. To make matters worse, this restriction can cause irritation that triggers even more adhesion formation.


Post-surgical adhesions can lead to other problems besides pain, depending on where inside the body they form. For example, adhesions in the bowels can cause diarrhea, constipation, or bowel obstruction (partial or complete blockage of the bowel), a potentially life-threatening condition. Post-surgical adhesions in the female reproductive tract can lead to painful intercourse or infertility.


Surgery pain is controlled mostly by medication - painkillers such as acetaminophen (brand names, Tylenol, Anacin AF, Panadol, and others). Managing surgery pain has become a high priority in hospitals and clinics. Reducing pain helps the body recover faster afar surgery. Following surgery, nurses constantly monitor your basic body functions, known as your vital signs. The four traditional vital signs are blood pressure, heart rate (pulse), body temperature, and breathing rate. Pain level, a fifth vital sign, is now widely recognized as an important health indicator.

In many cases, however, surgery pain caused by adhesions is chronic, lasting a long time. The usual treatment for chronic surgery pain is more surgery to remove or repair the adhesions. Repeat surgery can remove some internal scars, but it can also leave behind new adhesions that bring on pain - sometimes worse than before. Some alternative treatments for surgery pain have proven effective. Stress management, acupuncture, and certain types of physical therapy show promise for relieving surgery pain.

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