Chronic Post-Surgical Pain and Incisional Pain

Chronic Post Surgical Pain Summary

CPSP, Chronic Post Surgical Pain, is a surprisingly "new" disease. Of course, pain after surgery has been around for as long as surgery has been performed. And humans first performed surgery 8,000, possibly 14,000 years ago. But CPSP as a "big problem" was only recognized in 1998.

How Much Chronic Post Surgical Pain Is There?

US estimates are that between 400 thousand and 1.5 million people per year suffer from chronic post surgical pain. (400,000 - 1,500,000.) Measures to prevent CPSP, such as using different surgical techniques or using local anesthetic during the procedure, are improving, it is still a big problem. In one study of CPSP 28% of the patients had general surgical procedures (hernia, gallbladder, breast, colon, stomach, etc), 15% had vascular procedures (vein, artery, carotid artery, bypass, etc.), and 57% had either trauma or orthopedic surgery (broken bones, joint replacement, etc.) Most often the pain occurred in the joint (49%), incision area (38%), or the nerves (34%).

Treating Chronic Post Surgical Pain With Laser

CPSP is very responsive to high power high dose laser therapy. Laser increases blood flow and causes newvascularization (new blood vessels) which can greatly accelerate any healing process. Laser will also directly reduce nerve pain, while stimulating nerve growth factor to increase the amount and rate of nerve healing. Laser has a salutory effect on local immune responses and intracellular energy, and stimulates fibroblasts to promote healing.

What Causes CPSP?

The precise cause of any single case of CPSP is usually very speculative. CPSP can be caused when nerves are cut, crushed, or manipulated during surgery, as is so often necessary. However, CPSP can also occur when no demonstrable nerve damage has occurred. CPSP can be caused by tissue manipulation, and certainly gentler manipulation leads to less post-op pain. But there is no absolute correlation, and even when there is minimal tissue injury, CPSP can occur.

Read More About Chronic Post Surgical Pain

  1. First 10 years of CPSP
  2. Incidence of CPSP after general surgery
  3. Psychosocial factors predictors
  4. Epidemiology
  5. History of surgery