Post-Surgery Pain After Hemangioma Removal: What to Expect

Surgical removal of a hemangioma?

A few months ago, I developed a hemangioma on the inner thigh near the knee.
Initially, it was about the size of a bottle cap, but I suddenly experienced unexplained pain in my leg, so I immediately went to see a doctor.
After nearly a month of waiting for an MRI, during which time the tumor grew rapidly, I also developed cold-like pain that spread to my knee.
After a day's work, there would be significant swelling, but it would slightly reduce by the next morning.
When I finally had the MRI, it confirmed the presence of a tumor that was very close to the bone.
I scheduled surgery and was hospitalized the next day.
About a month after the surgery, I returned to work, but by the end of the second month, I frequently experienced sudden, unexplained sharp pains in my knee and at the incision site as well as the drainage tube site.
The pain in my knee felt the same as it did before the surgery.
This continued for a month, and when I consulted the surgeon who performed the operation, he couldn't provide a clear explanation and suggested I undergo rehabilitation or see an orthopedic specialist.
Could this be due to the tumor not being completely excised, or did I return to work too soon?

Da Xiong, 30~39 year old female. Ask Date: 2016/07/30

Dr. Zhou Hongzhang reply Plastic Surgery

1.
After surgery, unexplained pain at the wound site is often due to discomfort caused by the surgical trauma (whether from cutting, pulling, or cauterization).
In most cases, this will resolve after some time.

2.
Of course, the above phenomenon should be considered a diagnosis of exclusion, and primary conditions or other issues must be ruled out first.

Reply Date: 2016/07/30

More Info

After undergoing surgery for a hemangioma, particularly one located near the knee, it is not uncommon to experience post-operative pain and discomfort. Understanding the nature of this pain and what to expect during recovery is crucial for managing your symptoms effectively.

Firstly, it's important to recognize that surgical procedures, especially those involving tumors that are closely associated with bone structures, can lead to a variety of post-operative sensations. These may include sharp, stabbing pains, a feeling of tightness, or even a dull ache in the affected area. The pain you are experiencing in your knee and around the surgical site could be attributed to several factors:
1. Surgical Trauma: The process of removing a hemangioma involves cutting through skin, muscle, and possibly even bone. This trauma can lead to inflammation and irritation of the surrounding tissues, which may manifest as pain. The healing process can take time, and during this period, it is normal to experience fluctuations in pain levels.

2. Nerve Sensitivity: Surgery can also affect the nerves in the area. Nerve endings may become hypersensitive after trauma, leading to sensations of pain that may feel similar to what you experienced before surgery. This phenomenon is known as neuropathic pain and can sometimes persist for weeks or even months post-surgery.

3. Scar Tissue Formation: As your body heals, scar tissue forms at the surgical site. This scar tissue can sometimes adhere to surrounding tissues, leading to discomfort or pain during movement. The presence of scar tissue can also affect the range of motion in the knee, contributing to feelings of tightness or pain.

4. Activity Level: Returning to work and normal activities too soon after surgery can exacerbate pain. If you resumed your regular activities within a month of surgery, it is possible that the increased physical demands placed on your knee may have contributed to the pain you are experiencing. It is generally recommended to gradually increase activity levels and to listen to your body during the recovery process.

5. Infection or Complications: Although less common, it is essential to consider the possibility of infection or other complications following surgery. Symptoms such as increased redness, swelling, warmth, or discharge from the surgical site, along with persistent pain, should prompt a visit to your healthcare provider.

Given these factors, it is advisable to follow up with your surgeon or a specialist in orthopedics or rehabilitation. They can perform a thorough examination, possibly including imaging studies, to determine if there are any underlying issues such as incomplete removal of the tumor or other complications.
In the meantime, consider the following strategies to manage your pain:
- Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the knee, improve flexibility, and reduce pain. A physical therapist can provide tailored exercises that promote healing and recovery.

- Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may help alleviate discomfort. However, consult your doctor before taking any medication, especially if you have other health conditions or are taking other medications.

- Rest and Ice: Allowing your knee to rest and applying ice can help reduce inflammation and pain. Elevating the leg may also assist in minimizing swelling.

- Gradual Return to Activity: If you are experiencing pain, it may be beneficial to reduce your activity level temporarily. Gradually reintroducing activities can help you gauge your limits and avoid exacerbating your symptoms.

In conclusion, while post-operative pain is a common experience after hemangioma removal, persistent or severe pain should not be ignored. It is essential to communicate openly with your healthcare provider about your symptoms and concerns to ensure a safe and effective recovery process.

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