You have surgery to feel better. Whether it’s a joint replacement, back surgery, or even a minor procedure, most people expect the pain to ease up as they heal. But what if the pain sticks around long after your stitches are out and your incisions are closed?
If you’re still hurting months later, you’re not alone. Many people experience ongoing discomfort known as chronic post-surgical pain. Each year, nearly 40 million people have surgery, and according to the International Association for the Study of Pain, about 1 in 10 will develop chronic post-surgical pain. For one in 100, it can be severe enough to impact daily life significantly.[1]
It’s frustrating, confusing, and exhausting. Let’s talk about what might be going on, when to get help, and how pain management specialists can support your recovery.
What Is Chronic Post-Surgical Pain?
Chronic post-surgical pain (CPSP) is pain that lasts beyond the healing process after surgery and isn’t explained by other causes like infection or a new injury.[2] It’s usually nerve pain and can feel sharp, burning, aching, or even like pins and needles, affecting the surgical area or nearby body parts.[2]
CPSP is more common than many people think. Chronic post-surgical pain affects an estimated 5% to 85% of patients, depending on the type of surgery (like hernia repair, mastectomy, or joint replacements), with around 12% still experiencing moderate to severe pain a year after surgery.[2]
Why Am I Still Hurting Long After My Surgery?
Your incision has healed, and your doctor says everything looks fine, but you’re still hurting. Post-surgical pain that lingers often isn’t about something being “wrong” with the surgery. Instead, it has to do with how the body and nervous system respond.
Here are some possible causes:
- Nerve damage or irritation during surgery can cause the nerves to send pain signals even when the injury has healed.[3]
- Inflammation that persists for an extended period, even after the tissues have healed.[4]
- Central sensitization, where the nervous system becomes extra sensitive and continues to “feel” pain long after it should stop.[3]
- Scar tissue or adhesions pressing on nearby nerves or muscles.[2]
Sometimes, pain can also be related to other conditions that develop after surgery, like complex regional pain syndrome (CRPS), failed back surgery syndrome (FBSS) or myofascial pain.[5; 6] These are conditions where the pain response goes into overdrive, often needing specialized care.
Am I at Risk for Lingering Surgical Pain?
Not everyone develops chronic pain after surgery, but some people are more at risk than others. You may be more likely to experience CPSP if:
- You had severe pain before surgery or right after surgery.[7]
- The procedure involved nerve-dense areas, like the chest, abdomen, or spine.[7]
- You have a history of chronic pain, depression and anxiety, which can affect how the body processes pain.[3]
- You have other conditions like IBS, migraines, fibromyalgia and Raynaud’s syndrome.[3]
- You’re undergoing specific procedures like amputations, thoracotomies, or mastectomies, which are more strongly linked to chronic pain afterward.[3]
When Should I Seek Help for Chronic Post-Surgical Pain (CPSP)?
If you’re still experiencing pain three months or more after surgery, it’s important to seek help, especially if that pain is interfering with your daily life. This could be a sign of Chronic Post-Surgical Pain (CPSP), a condition where pain continues well beyond the expected healing period without another identifiable cause. CPSP can significantly affect mobility, sleep, mood, and overall recovery if left untreated.
A pain management specialist can help determine the source of your discomfort and recommend targeted treatments such as physical therapy, medications, or image-guided procedures. Don’t wait for the pain to become unbearable—early intervention can lead to better outcomes and an improved quality of life.
Here are some signs it’s time to talk to a specialist:
- You had pain before surgery that never really went away.
- Pain persists or worsens instead of improving.
- Pain is debilitating, limiting your sleep, mobility, or daily activities.
- Pain isn’t well-controlled, even with medications.
- You’re concerned about how much medication you’re taking or want to reduce it.
Medication can be helpful, but it has its limitations. This is where interventional pain management comes in, and pain specialists can offer options beyond pills to help you feel better.
How Pain Management Can Help with Chronic Postoperative Pain
Interventional pain management specialists are trained to look beyond traditional treatments and consider the whole picture, encompassing not only the surgical site but also how pain affects the body and mind. They use tools like imaging, nerve tests and your medical history to determine why you still have pain.
Your pain management treatment plan may include:
- Nerve blocks or injections
- Spinal cord stimulators
- Peripheral nerve stimulations
- Radiofrequency ablation
- Epidural steroid injections
- Facet Joint Injections
- Radiofrequency neurotomy
- Trigger Point Injections
- Intrathecal drug delivery systems (pain pumps)
- Topical pain patches
- Physical therapy
- Mental health support
Most importantly, they work closely with you and your medical team to create a personalized plan to help you get your life back on track.
Pain after surgery is supposed to go away, but if it doesn’t, you don’t have to live with it. Chronic post-surgical pain is real (it’s not just in your head), and you deserve answers and relief. Talk to a pain specialist.
There are options for pain relief, and there is hope for better days.
Resources:
- Prevention of Chronic Post-Surgical Pain. International Association for the Study of Pain (IASP) [Internet]. Published July 09, 2021. Accessed May 29, 2025. Available from: https://www.iasp-pain.org/resources/fact-sheets/prevention-of-chronic-post-surgical-pain/
- Thapa P, Euasobhon P. Chronic postsurgical pain: current evidence for prevention and management. Korean J Pain [Internet]. 2018;31(3):155-173. doi:10.3344/kjp.2018.31.3.155. Accessed May 29, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6037807/
- Neil MJ, Macrae WA. Post Surgical Pain- The Transition from Acute to Chronic Pain. Rev Pain [Internet]. 2009;3(2):6-9. doi:10.1177/204946370900300203. Accessed May 29, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4590044/
- Rosenberger DC, Pogatzki-Zahn EM. Chronic post-surgical pain – update on incidence, risk factors and preventive treatment options. BJA Education [Internet]. 2022;22(5). doi:https://doi.org/10.1016/j.bjae.2021.11.008. Accessed May 29, 2025. Available from: https://www.bjaed.org/article/S2058-5349(21)00153-0/fulltext
- Kraychete DC, Sakata RK, Lannes L de OC, Bandeira ID, Sadatsune EJ. Postoperative persistent chronic pain: what do we know about prevention, risk factors, and treatment. Brazilian Journal of Anesthesiology (English Edition) [Internet]. 2016;66(5):505-512. doi:https://doi.org/10.1016/j.bjane.2014.12.005. Accessed May 29, 2025. Available from: https://www.scielo.br/j/rba/a/P9QZpvFC86gRcgpPjMh9Psp/
- Hachisuka R, Taguchi S, Moriwaki K, Oshita K, Umeda A, Tsutsumi YM. Subacute postoperative myofascial pain diagnosed and treated successfully by ultrasound: a case after laparoscopic hepatectomy. JA Clin Rep [Internet]. 2022;8(1):53. Published 2022 Jul 19. doi:10.1186/s40981-022-00540-5. Accessed May 29, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9296717/
- Rosenberger DC, Pogatzki-Zahn EM. Chronic post-surgical pain – update on incidence, risk factors and preventive treatment options. BJA Educ [Internet]. 2022;22(5):190-196. doi:10.1016/j.bjae.2021.11.008. Accessed May 29, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9039436
