Managing Post-Surgery Pain: Tips for Recovery After Orthopedic Surgery

Fourth week post-operative after internal fixation with a plate?

It has been one month since my surgery from the car accident.
The swelling started to subside around the second week.
Since then, I frequently experience sharp pain in my toes, the soles of my feet, and the tops of my feet.
Sometimes the pain is quite intense and can suddenly occur just as I'm about to fall asleep, which causes me a lot of distress.
It feels as if someone is continuously stabbing the tips of my toes with a needle.
I have consulted my attending physician, who said that this condition is normal, but I forgot to ask him what methods could alleviate this pain.
Each time I return for a follow-up, the doctor prescribes me antipyretic analgesics (fucole paran 500mg), but they seem ineffective for this issue.
Now, after one month, this sensation still frequently occurs, especially at night when I'm trying to sleep.
I would like to ask the doctor if there are no other methods available and if I just have to endure it.
If enduring is the only option, how long should I expect to endure this? I hope there are ways to relieve this discomfort.

Yiyang, 20~29 year old female. Ask Date: 2020/10/26

Dr. Chen Bochen reply Orthopedics

Neuropathic sensations can consider the following two adjunctive treatments: 1.
Gabapentin (should be taken after evaluation by a physician) 2.
Vitamin B complex.
Soaking in warm water to enhance local circulation can also be beneficial.

Reply Date: 2020/10/26

More Info

Post-surgery pain management, especially after orthopedic surgery, can be a challenging experience for many patients. It is not uncommon to experience discomfort, including sharp, stabbing pains in the extremities, as you have described. These sensations can be particularly distressing when they occur at night, disrupting sleep and overall quality of life. Here are some insights and recommendations based on your situation.

Understanding Post-Surgical Pain
After surgery, especially following trauma like a car accident, the body undergoes a healing process that can involve inflammation, nerve irritation, and changes in blood flow. The pain you are experiencing in your toes and feet may be attributed to several factors:
1. Nerve Regeneration: If nerves were affected during the surgery, they might be in the process of healing. This can lead to sensations like tingling, stabbing, or shooting pain, often referred to as neuropathic pain.

2. Phantom Pain: Sometimes, patients experience pain in areas that were not directly involved in the surgery. This phenomenon can occur due to the brain's interpretation of signals from the nervous system.

3. Muscle and Joint Pain: After surgery, surrounding muscles and joints may become stiff or tense, leading to discomfort, especially when pressure is applied.

Pain Management Strategies
While your doctor has prescribed pain relief medication, it may not be sufficient for the type of pain you are experiencing. Here are some additional strategies that may help alleviate your discomfort:
1. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can guide you through exercises that promote mobility, strengthen muscles, and improve circulation, which can help reduce pain.

2. Heat and Cold Therapy: Alternating between heat and cold can provide relief. Cold packs can reduce inflammation, while heat can relax tense muscles. Applying these treatments for 15-20 minutes at a time may help.

3. Pain Management Techniques: Consider exploring non-pharmacological pain management techniques such as:
- Mindfulness and Relaxation Techniques: Practices like deep breathing, meditation, or yoga can help manage pain perception.

- Acupuncture: Some patients find relief through acupuncture, which may help stimulate the body's natural pain-relieving mechanisms.

- Transcutaneous Electrical Nerve Stimulation (TENS): This method uses low-voltage electrical currents to relieve pain.

4. Medication Review: If the current medication is not effective, discuss with your doctor the possibility of adjusting your pain management plan. There are various classes of medications available, including:
- Antidepressants or Anticonvulsants: These can be effective for neuropathic pain.

- Topical Analgesics: Creams or patches that contain pain-relieving ingredients can be applied directly to the painful area.

5. Sleep Hygiene: Since your pain disrupts your sleep, consider implementing good sleep hygiene practices. This includes maintaining a regular sleep schedule, creating a comfortable sleep environment, and avoiding stimulants before bedtime.

When to Seek Further Help
If your pain persists or worsens despite trying these strategies, it is crucial to communicate this to your healthcare provider. They may need to investigate further to rule out complications such as infection, improper healing, or other underlying issues.

In conclusion, while post-surgical pain can be a normal part of the recovery process, it is essential to actively manage it to improve your quality of life. By combining medical treatment with physical therapy and self-care strategies, you can work towards alleviating your discomfort and enhancing your recovery experience. Always keep an open line of communication with your healthcare team to ensure that your pain management plan is effective and tailored to your needs.

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