Impact of surgery and trauma in developing chronic pain

Surgery and trauma are recognized as important causes of chronic pain. In this manusript, we analyzed the patients who visited our clinic with posttraumatic or delayed surgical pain complaints between January 2001 and January 2004. Identification and evaluation of pain were done as defined in the taxonomy of IASP. Duration and severity of pain as well as diagnosis and etiology were evaluated as suggested in the taxonomy. Our results showed that 107 out of 2866 patients (4 %) were diagnosed of having chronic pain related to the history of trauma or surgery. The age range of the patients was from 32 to 66 years with an average of 48 years. Male/female ratio was 35/72. The duration of pain varied. 15 % of the patients complained of pain lasting for 1 to 6 months, 67 % complained of pain lasting for 6 to 24 months, and 18 % complained of pain lasting more than 24 months. A significant amount of patients (72 %) complained of very severe pain, 21 % complained of moderate pain, and finally only 7 % complained of mild pain. The diagnosis of pain were as follows: radiculopathy and postlaminectomy pain in 48 %, neuropathic pain in 33 %, phantom pain in 12 %, carpal syndrome in 6 %, and thalamic syndrome in 1 %. Pathogenesis of pain was evaluated to be originating from peripheral nervous system in 56 %, muscle and skeletal system in 43 %, and central nervous system in 1 % of the cases. Additionally, fifty-nine percent of the cases complained of back pain. Long-term (?1 year) and continuous follow up of postoperative and posttraumatic pain during acute course may prevent a significant amount of chronic pain complaints.

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