Post-Surgical Pain: Causes and Management Strategies

Postoperative pain

I underwent traditional surgery on April 24, and on May 2, I returned to the hospital for sutures due to bleeding.
The sutures will take about a month to absorb.
However, starting from April 30 and May 9, I began experiencing pain only on the left side, which doesn't feel like pain from the incision.
Instead, it feels like pain in the soft tissue on both sides of the buttocks and around the vaginal area, as if someone is squeezing the bruised area.
This pain can make my legs feel weak and shaky; I need to support my buttocks while walking and even while sleeping.
If my buttocks are unsupported, the pain intensifies.
This sensation has not improved day by day.
What could be the cause of this?

vicky, 20~29 year old female. Ask Date: 2020/05/12

Dr. Yu Mingchang reply Surgery

You can visit the surgical outpatient clinic for evaluation.

Reply Date: 2020/05/12

More Info

Post-surgical pain is a complex phenomenon that can arise from various factors related to the surgical procedure itself, the patient's individual anatomy, and their overall health status. Understanding the causes of post-surgical pain and effective management strategies is crucial for improving patient outcomes and quality of life.

In your case, the pain you are experiencing seems to be localized around the buttocks and vaginal area, which could be attributed to several potential causes. First, it is important to consider the type of surgery you underwent and the anatomical structures involved. Surgical procedures can lead to inflammation, nerve irritation, or even damage to surrounding tissues, which may manifest as referred pain in areas that are not directly related to the surgical site.

One possible explanation for your symptoms is the presence of nerve irritation or entrapment. During surgery, nerves can be stretched, compressed, or otherwise affected, leading to sensations of pain, tingling, or weakness in the areas they innervate. This could explain the feeling of weakness in your legs and the need to support yourself while walking or sleeping. Additionally, the pain described as a "bruised" feeling could indicate that the soft tissues in the area are inflamed or healing improperly.

Another consideration is the possibility of myofascial pain syndrome, which can occur when muscles and fascia (the connective tissue surrounding muscles) become tense or develop trigger points due to surgical trauma. This can lead to localized pain that may feel like it is radiating to other areas, such as the buttocks and thighs. The sensation of needing to support your buttocks while sitting or lying down could further suggest that the muscles in that region are not functioning optimally, leading to discomfort.

In terms of management strategies, it is essential to address both the physical and psychological aspects of pain. Here are some recommendations:
1. Pain Management Medications: Consult with your healthcare provider about appropriate pain relief options. This may include non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or even prescription medications if the pain is severe.

2. Physical Therapy: Engaging in physical therapy can be beneficial in addressing muscle imbalances, improving mobility, and reducing pain. A physical therapist can design a tailored program that focuses on strengthening the muscles around the affected area and improving overall function.

3. Gentle Stretching and Mobility Exercises: Incorporating gentle stretching and mobility exercises can help alleviate tension in the muscles and improve circulation to the affected areas. However, it is crucial to avoid any movements that exacerbate your pain.

4. Heat and Cold Therapy: Applying heat or cold to the affected areas can provide temporary relief. Heat can help relax tense muscles, while cold therapy can reduce inflammation and numb sharp pain.

5. Mind-Body Techniques: Techniques such as mindfulness, meditation, or guided imagery can help manage the psychological aspects of pain. Stress and anxiety can exacerbate pain perception, so finding ways to relax and cope with discomfort is essential.

6. Follow-Up with Your Surgeon: Since your symptoms have persisted, it is vital to follow up with your surgeon or healthcare provider. They may want to conduct further evaluations, such as imaging studies, to rule out complications like hematomas or infections that could be contributing to your pain.

7. Consider Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture, chiropractic care, or massage therapy. These should be approached cautiously and discussed with your healthcare provider to ensure they are safe and appropriate for your situation.

In conclusion, post-surgical pain can be multifaceted and may require a comprehensive approach to management. It is essential to communicate openly with your healthcare team about your symptoms and concerns, as they can provide tailored recommendations based on your specific situation. With the right strategies in place, many patients can find relief and improve their quality of life following surgery.

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