Pain control in the postoperative patient can have a notable effect on the overall outcome of the patient and surgical procedure. Orthopaedic surgeries are among the most painful surgical procedures, and patients are at high risk of inadequate postoperative pain control.1-3 Among ambulatory procedures, ankle surgeries in particular have been found to be among the most painful.2 Patients undergoing open treatment for ankle fractures are at risk for long-term pain and disability.1-4 However, few studies exist in the literature assessing postoperative pain and management in the ankle fracture patient.
In a prospective study of patients undergoing a variety of foot and ankle surgeries, Chou et al showed that the preoperative pain level was predictive of patient-anticipated postoperative pain and actual postoperative pain.5 In addition, anticipated postoperative pain was an independent predictor of postoperative pain in the early postoperative period.
The purpose of this study was to characterize the preoperative and postoperative pain experienced by patients undergoing open reduction and internal fixation (ORIF) of ankle fractures, relatively common injuries that frequently require surgical reduction and fixation. We hypothesized that ankle fracture patients would have substantial postoperative pain at three days and six weeks after surgical treatment and that their preoperative anticipated level of pain would correlate with the severity of postoperative pain. By understanding the pain experience after ankle fracture surgery, orthopaedic surgeons are better equipped to educate patients about expected pain after surgery, as well as to optimize the treatment regimen for pain during the postoperative period.
After institutional review board approval, 63 consecutive patients were asked to participate in this study before undergoing ORIF of ankle fractures. The study period was December 2006 to April 2010. All patients provided informed consent to participate. Patients who declined participation, did not speak English, or had a history of chronic opioid or substance abuse were excluded from the study. All patients were treated by one of two orthopaedic foot and ankle specialists at a single institution. One patient did not return for follow-up and therefore did not complete the study.
Patient demographics and fracture characteristics are listed on Table 1. A total of 29 women and 34 men were included. The average age was 41 years (range, 18 to 85 years). No other surgical injuries sustained at the time of the ankle fracture injury. No patients with polytrauma or patients with open fractures were included. Fifty-one fractures that did not require syndesmotic repair were as follows: 30 isolated lateral malleolus fractures, 16 bimalleolar fractures (ie, medial and lateral malleoli), 3 isolated medial malleolar fractures, and 2 trimalleolar fractures. Twelve injuries involved the syndesmosis that required repair: five in conjunction with a lateral malleolus fracture, four isolated tibial-fibular syndesmosis injuries, and three bimalleolar fractures (ie, two medial and lateral malleoli and one posterior and lateral malleoli).
Twenty-seven patients were treated as outpatients, 23 patients were kept for 23-hour observation as outpatients, and 13 patients were admitted to the hospital. The inpatients were admitted to the hospital for a mean of 1.9 nights (range, 1 to 15 nights). For outpatients, postoperative pain was managed by the patient with oral analgesics using a standard regimen. Most outpatients were given prescriptions for acetaminophen with hydrocodone postoperatively, except where specific indications existed for the use of an alternative medication. Inpatients were treated with patient-controlled analgesia with hydromorphone. On discharge from the hospital, all patients were given prescriptions for acetaminophen with hydrocodone. Forty-nine of the 63 patients were administered regional nerve blocks.
The Short-Form McGill Pain Questionnaire (SF-MPQ) was used. The SF-MPQ is sufficiently sensitive to reflect differences because of treatment.6 It includes the Present Pain Intensity (PPI) of the Standard McGill Pain Questionnaire and a visual analog scale (VAS). The PPI is scored on a categoric scale of 0 to 5 as no pain (0), mild (1), discomforting (2), distressing (3), horrible (4), and excruciating (5). The VAS is measured on a continuous scale between 0 and 10 cm.
In addition, the questionnaire lists 15 descriptors of pain (ie, 11 sensory and 4 affective), which are rated on an intensity scale as 0 = none, 1 = mild, 2 = moderate, or 3 = severe. Three pain scores are calculated from the sum of the intensity rank values for sensory (SPRI, maximum score 33), affective (APRI, maximum score 12), and total (TPRI = SPRI + APRI, maximum score 45).
Patients were given an SF-MPQ at each of the three different time points: (1) at the preoperative visit 1 to 7 days before the surgery (PP), (2) 3 days after the surgery (3dPP), and (3) 6 weeks after the surgery (6wPP). At their preoperative visit, they were also asked to rate their anticipated postoperative pain (APP) using the SF-MPQ. The surveys were filled by the patient with the assistance of one of the investigators in person or over the telephone.
Power analysis indicated that a sample size of 25 would be sufficient for statistical significance with our primary outcome variable.
Mean values, SDs, and 95% confidence intervals (CIs) for each type of pain score at respective time intervals were calculated. Pearson correlations were calculated using StatView v5.1 to determine the predictive value of PP and APP with respect to 3dPP and 6wPP.
Multivariate linear regression models were performed to assess predictors of postoperative pain scores with respect to sex, age, and inpatient vs. outpatient status. ANOVA was used to evaluate for significant differences in pain scores at each time interval depending on the fracture type.
Pain was most severe at the 3-day postoperative assessment and had decreased markedly by 6 weeks postoperatively. At the 6-week postoperative assessment, most patients felt little or no pain. This was true for both the PPI and VAS pain scores (Figure 1).
The mean PPI and VAS scores were calculated at each time point (Table 2). On the PPI scale, PP was 2.49 (SD, 1.57; 95% CI, 2.10 to 2.89), APP was 2.75 (SD, 1.08; 95% CI, 2.47 to 3.03), 3dPP was 2.91 (SD, 1.34; 95% CI, 2.56 to 3.26), and 6wPP was 0.35 (SD, 0.71; 95% CI, 0.17 to 0.53). On the VAS scale, PP was 4.35 (SD, 3.31; 95% CI, 3.53 to 5.17), APP was 5.75 (SD, 2.68; 95% CI, 5.06 to 6.44), 3dPP was 5.25 (SD, 3.17; 95% CI, 4.43 to 6.06), and 6wPP was 0.63 (SD, 1.48; 95% CI, 0.32 to 0.95). Overlap was found in the 95% CI between PP, APP, and 3dPP on both the PPI and VAS scales, indicating no significant differences in these values. The 6wPP was markedly lower than PP, APP, and 3dPP on the PPI and VAS scales.
Using Pearson coefficients, PP was compared with APP, 3dPP, and 6wPP. APP was also compared with 3dPP and 6wPP (Table 3). PP and APP ratings were strongly correlated. This correlation was found to be significant for preoperative and anticipated VAS, PPI, Sensory Present Pain Intensity (SPRI), Affective Present Pain Intensity (APRI), Total Present Pain Intensity (TPRI), and PPI (r = 0.59, 0.45, 0.54, 0.64, and 0.56, respectively, P < 0.001). On the VAS scale, APP was more strongly correlated with 3dPP and 6wPP (r = 0.53, P < 0.001 and r = 0.36, P < 0.01, respectively) than PP was correlated with 3dPP and 6wPP (r = 0.34, P < 0.01 and r = 0.29, P < 0.05, respectively). On the PPI scale, PP and APP were significantly correlated with 3dPP (r = 0.27 and 0.32, respectively, P < 0.05), but only APP was correlated with 6wPP (r = 0.34, P < 0.01).
Multivariate linear regression analysis found that both PP and APP VAS scores were independent predictors of 3dPP and 6wPP VAS scores. APP but not PP was a notable predictor of 3dPP and 6wPP PPI scores. Sex, age, and inpatient versus outpatient status were not found to be markedly associated with VAS or PPI at the 3-day and 6-week postoperative assessments.
Analysis of variance (ANOVA) was used to compare pain scores between the different fracture types at each time interval. Single malleolar fractures (lateral and medial malleolus only, n = 33), bimalleolar fractures (n = 18), and syndesmotic injuries with or without associated fracture (n = 12) were compared. Trimalleolar fractures were not included in this analysis because only two samples were available. No significant differences were found between the fracture types on either the PPI or VAS scale at any time point.
Pain control after open repair of ankle fractures requires appropriate management of patient expectations and medication use in the perioperative period. Chung et al1 found that more than 10% of ambulatory surgery patients undergoing ankle procedures have severe pain in the post-anesthesia care unit. These patients frequently require large amounts of narcotics and are at risk of long-term use of pain medications. Among ambulatory surgery patients, postoperative pain is associated with prolonged post-anesthesia care unit stay, an increased rate of unanticipated admission or readmission after surgery, and increased cost.1-4,7,8
Chou et al found that among patients undergoing orthopaedic foot and ankle surgeries, patients experienced greater postoperative pain than anticipated and that preoperative pain and anticipated pain were highly predictive of postoperative pain.5 However, their study evaluated patients undergoing a broad variety of foot and ankle procedures, which may result in a spectrum of pain experiences.
In patients undergoing ORIF of ankle fractures, pain levels were highest preoperatively and in the early postoperative period, and no significant differences were found in PP, APP, and 3dPP. Pain scores were markedly decreased by 6 weeks. PP and APP were predictive of 3dPP, whereas only APP was predictive of 6wPP.
Patients with isolated lateral malleolus fractures had lower levels of pain. In fact, 14.3% (5/35) had a preoperative VAS score of zero. By 6 weeks, 71.4% (25/35) had a VAS score of zero, and no patient had a 6-week VAS score of more than 3.8. Isolated lateral malleolar fractures have demonstrated improved outcomes compared with other ankle fracture types.9
Previous studies have demonstrated that patients who require syndesmotic stabilization in addition to malleolar fixation have poorer functional outcomes after surgical treatment compared with patients who require malleolar fixation alone.10,11 In a retrospective review of 347 patients who underwent surgical fixation of unstable ankle fracture, Egol et al7 found that the syndesmotic injury group (n = 79) had markedly greater dysfunction and worse AOFAS scores compared with the nonsyndesmotic injury group (n = 268).10 This finding was independent of the presence of fracture-dislocation, suggesting that syndesmotic injury in itself is predictive of more severe injury and worse outcomes. The authors also compared the syndesmotic injury subgroup who had broken or electively removed screws (n = 26) with the group without syndesmotic injury (n = 268) and found that the nonsyndesmotic injury group reported markedly less pain at 1-year follow-up. These findings are limited by the retrospective nature of the study and the small sample size of patients with broken or electively removed screws.
In this study, no statistically significant difference was found in pain scores between nonsyndesmotic and syndesmotic ankle fractures. However, when isolated syndesmotic injuries without associated fracture (n = 4) were evaluated separately, the average preoperative pain score and APP were higher than the overall mean pain scores on the VAS scale (PP syndesmosis 9.06 versus overall 4.35, APP syndesmosis 9.53 versus overall 5.75) and PPI scale (PP syndesmosis 3.75 versus overall 2.49, APP syndesmosis 4.25 versus overall 2.75). Postoperative pain scores at 3 days and 6 weeks were similar to overall average scores. A larger sample of patients is necessary to determine whether these differences are statistically significant.
The patients who sustained trimalleolar fractures in our study were not included in statistical comparisons between fracture types because of the small sample size (n = 2). However, they both exhibited high preoperative pain scores (VAS 10.5 and 9.4, respectively) and persistently high pain scores at 6-week follow-up (VAS 3.5 and 7.0, respectively). Tejwani et al demonstrated in a prospective study of surgically treated unstable ankle fractures that trimalleolar ankle fractures had markedly worse outcomes compared with other fractures types.12 Studies have also shown that worse outcomes are associated with larger posterior malleolar fragment size.13,14 Additional studies with a larger number of patients are necessary to determine whether trimalleolar fractures are associated with markedly higher pain scores in the perioperative period.
Although most focus in practice is placed on postoperative pain control, our findings suggest that postoperative pain levels are closely associated with preoperative and anticipated pain levels. This finding has been described in many types of orthopaedic procedures. Desai and Cheung found a similar association in shoulder and elbow surgery patients.15 Using the SF-MPQ, they found that both PP and APP were independent predictors of postoperative pain levels at 3 days and 6 weeks. These findings highlight the importance of the preoperative period in predicting postoperative pain, as well as preparing and educating the patient. The phenomenon of central sensitization, the priming of nociceptive pathways to a heightened level of excitability and responsiveness, has been implicated in the association between the preoperative and postoperative pain levels16,17 and may direct future efforts to preemptively treat pain.
The patient's own perception of how severe their pain will be postoperatively independently predicted pain at both early and extended postoperative intervals, and it was a better predictor than the preoperative pain level. Although this may reflect a patient's own self-awareness and ability to predict their pain, this may also point to the complex interactions of various mediators on the actual pain experience. Studies have demonstrated that American patients are more frequently prescribed narcotics postoperatively and experience less satisfaction with their pain relief compared with patients of other countries. Lindenhovious et al found higher rates of narcotic use in both inpatient and outpatient settings in American versus Dutch patients.17 Whereas 98% of American patients used narcotics during their hospitalization, 64% of Dutch patients used narcotics. Similarly, although 82% of American patients were prescribed narcotic pain medication after hospital discharge, only 6% of Dutch patients were discharged with narcotics. The same group showed that American patients had higher pain ratings and less satisfaction with their pain relief compared with Dutch patients.18 Nationality and use of opioid medications were independent predictors of higher pain levels. These studies indicate that sociological and psychosocial factors play a notable role in the pain experience.
The findings of this study should be interpreted in light of certain limitations. Although most patients received the same postoperative pain management protocol, some variation was observed in the use of regional blocks and the duration and amount of postoperative opioid use. Current opioid use was not measured at follow-up. Although this may introduce some bias into the study, opioid use has been shown to be associated with worse pain, rather than ameliorating pain.18 Although patients with a history of chronic opioid or substance abuse were excluded, we did not obtain a history of previous pain experiences, such as previous injury or surgery. A second limitation was that some of the postoperative evaluations were conducted via telephone interview, which may confound some of our data. Telephone interviews were conducted by one of the authors, who assisted the patient in completing the SF-MPQ form. The completed form was then brought in at the patient's follow-up clinic visit. A third limitation was that the total number of patients with ankle fractures treated at this institution was not collected. A fourth limitation was that the patients who received regional nerve blocks were not taken into account with the overall pain experience. The aim of this study was to evaluate preoperative and postoperative pain experienced by patients undergoing surgical treatment of ankle fractures, This was done as an initial study, and future studies will include regional anesthesia effects.
Perhaps the greatest limitation of this study is the small number of patients in each fracture category, which could result in under-powering of some of our statistical comparisons. Furthermore, although we grouped all patients with syndesmotic injuries together, some of these patients had more severe injury patterns than others and may experience greater pain. Interestingly, in our study, it was the patients with isolated syndesmotic injuries who appeared to have greater preoperative pain than the syndesmotic injuries with associated fractures. However, the significance of this finding is not clear without a larger sample of patients. Finally, we had only two patients with trimalleolar fractures and were not able to include their data in statistical comparisons. Future studies should focus on these particular subsets of patients.
Our results demonstrate that both preoperative pain intensity and the pain levels that patients anticipate experiencing postoperatively are highly correlated with the postoperative pain experience after surgical treatment of ankle fracture. In addition, most patients experience notable pain immediately after ankle fracture fixation despite commonly used opioid regimens, indicating that current methods may not be sufficient. Anticipation of postoperative pain is important for patient counseling, formulating the postoperative pain control regimen, and estimating the duration of hospital stay. However, most patients also have little to no pain by 6-week follow-up. The pain experience is shaped by a complex milieu of neurologic, cultural, and psychosocial factors. The most effective methods may require supplementation of current regimens with regional blocks and opioid adjuvants, in addition to implementing preemptive, cognitive, and behavioral strategies.19 Additional studies are needed to determine whether these data apply to other foot and ankle and orthopaedic procedures.
1.Chung F, Ritchie E, Su J. Postoperative pain in ambulatory surgery. Anesth Analg 1997;85:808-816.
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2.McGrath B, Elgendy H, Chung F, Kamming D, Curti B, King S. Thirty percent of patients have moderate to severe pain 24 hr after ambulatory surgery: A survey of 5,703 patients. Can J Anaesth 2004;51:886-891.
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3.Rawal N, Hylander J, Nydahl PA, Olofsson I, Gupta A. Survey of postoperative analgesia following ambulatory surgery. Acta Anaesthesiol Scand 1997;41:1017-1022.
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4.Sinatra RS, Torres J, Bustos AM. Pain management after major orthopaedic surgery: Current strategies and new concepts. J Am Acad Orthop Surg 2002;10:117-129.
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5.Chou LB, Wagner D, Witten DM, et al. Postoperative pain following foot and ankle surgery: A prospective study. Foot Ankle Int 2008;29:1063-1068.
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6.Melzack R. The short-form McGill pain questionnaire. Pain 1987;30:191-197.
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7.Chung F, Mezei G. Factors contributing to a prolonged stay after ambulatory surgery. Anesth Analg 1999;89:1352-1359.
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8.Coley KC, Williams BA, DaPos SV, Chen C, Smith RB. Retrospective evaluation of unanticipated admissions and readmissions after same day surgery and associated costs. J Clin Anesth 2002;14:349-353.
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9.Tejwani NC, McLaurin TM, Walsh M, Bhadsavle S, Koval KJ, Egol KA. Are outcomes of bimalleolar fractures poorer than those of lateral malleolar fractures with medial ligamentous injury? J Bone Joint Surg Am 2007;89:1438-1441.
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10.Egol KA, Pahk B, Walsh M, Tejwani NC, Davidovitch RI, Koval KJ. Outcome after unstable ankle fracture: Effect of syndesmotic stabilization. J Orthop Trauma 2010;24:7-11.
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11.Manjoo A, Sanders DW, Tieszer C, MacLeod MD. Functional and radiographic results of patients with syndesmotic screw fixation: Implications for screw removal. J Orthop Trauma 2010;24:2-6.
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12.Tejwani NC, Pahk B, Egol KA. Effect of posterior malleolus fracture on outcome after unstable ankle fracture. J Trauma 2010;69:666-669.
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13.McDaniel WJ, Wilson FC. Trimalleolar fractures of the ankle. An end result study. Clin Orthop Relat Res 1977:37-45.
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14.Mont MA, Sedlin ED, Weiner LS, Miller AR. Postoperative radiographs as predictors of clinical outcomes in unstable ankle fractures. J Orthop Trauma 1992;6:352-357.
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15.Desai VN, Cheung EV. Postoperative pain associated with orthopaedic shoulder and elbow surgery: A prospective study. J Shoulder Elbow Surg 2012;21:441-450.
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16.Aida S, Fujihara H, Taga K, Fukuda S, Shimoji K. Involvement of presurgical pain in preemptive analgesia for orthopaedic surgery: A randomized double blind study. Pain 2000;84:169-173.
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17.Lindenhovious AL, Helmerhorts GT, Schnellen AC, Vrahas M, Ring D, Kloen P. Differences in prescription of narcotic pain medication after operative treatment of hip and ankle fractures in the United States and The Netherlands. J Trauma 2009;67:160-164.
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18.Helmerhorst GT, Lindenhovius AL, Vrahas M, Ring D, Kloen P. Satisfaction with pain relief after operative treatment of an ankle fracture. Injury 2012;43:1958-1961.
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19.Stein BE, Srikumaran U, Tan EW, Freehill MT, Wilckens JH. Lower-extremity peripheral nerve blocks in the perioperative pain management of orthopaedic patients. J Bone Joint Surg Am 2012;94:e167.
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For most foot and ankle operations, tenderness and swelling can take 3-4 months to resolve, while for more complicated procedures, the recovery may take a full year (or more).When is the most pain after ankle surgery? ›
Patients, on average, experienced higher pain intensity 3 days after the operation than anticipated. The postoperative pain intensity at 3 days was the most severe, while postoperative pain intensity at 6 weeks was the least severe.Why does my ankle hurt years after surgery? ›
According to our Tarrant County podiatrist, chronic post-surgical pain after foot surgery can occur for a variety of reasons, including: Tissue damage and inflammation. Damage to a nerve or nerves. Formation of scar tissue.Is it normal to have severe pain after ankle surgery? ›
Expect to be in some degree of pain following surgery. The bones in your foot and/or ankle are being manipulated in the operating room to correct the problem, which will cause pain. In general, the pain subsides after a few days to a week after surgery, depending on the type of surgery.How do you get rid of ankle pain after surgery? ›
Your ankle surgeon and physical therapist may also recommend the RICE method to help quell the pain during your recuperation, and this stands for Rest, Ice, Compression, and Elevation of the affected area. Do not place ice on bare skin, as it can overexpose your skin to the cold temperature.Why does my ankle hurt months after surgery? ›
Pain After Surgery May Indicate a Nerve Problem
This process may be as short as a few weeks or as long as several months, depending on the severity of the initial pain, the extensiveness of the surgery or treatment, and how well you follow up with home care.
Motrin or Advil (ibuprofen) 600mg every 6 hours OR Celebrex 100mg every 12 hours. Tylenol (acetaminophen) 650mg every 6 hours. Neurontin (gabapentin) 300mg every 8 hours for the first 3 days only. Hydroxyzine 25mg (or 10mg if >65 years of age) every 6 hours.How do I get my foot to stop hurting after surgery? ›
In addition to resting your foot, your doctor is also likely to recommend a routine of ice, compression and elevation after the surgery. Specifically, ice works wonders when it comes to reducing swelling and inflammation, which can in-turn relieve pain and discomfort.Will my ankle pain ever go away? ›
Most ankle sprains will heal with standard RICE therapy (rest, ice, compression and elevation) within two to 12 weeks. But for the patients with sprains that do not heal over time with standard therapy, both the cause and next steps for treatment can be unclear.How long does nerve pain last after ankle surgery? ›
It is not uncommon to experience some shooting nerve pain after surgery it will usually diminish in intensity and frequency every few days but can last up to 4-6 weeks.
For how long will I experience swelling and/or discomfort in my foot/ankle? You can expect swelling, discomfort or hypersensitivity for up to one year after fracture. This is normal and does not mean there is anything to worry about.How long does it take to recover from ankle surgery with plates and screws? ›
They might also install metal plates, wires, or screws to keep your ankle bones stable while the bones heal. Recovery from this surgery takes at least 6 to 8 weeks. Severe fractures take up to 12 weeks to heal.How long does it take for nerves to regenerate after ankle surgery? ›
You'll have follow-up appointments with your surgeon, during which he determines how your nerve regeneration is progressing. Nerve fibers have to grow down the full length of the damaged nerve to where the nerve and muscle intersect. That can take between six months to one year.What not to do after ankle surgery? ›
In the days and weeks after surgery, you'll likely be told to avoid putting too much (if any) weight on your foot, avoid unnecessary physical labor, and rest as much as possible. You'll also, obviously, prefer to avoid any preventable accidents when moving around the house, or navigating up and down stairs.How long does it take to walk normally after ankle surgery? ›
No walking on the foot is permitted until the wound is reviewed 2 weeks after surgery. At that time you will be allowed to walk in a walking boot. It will take about 3 months before the ankle starts to feel comfortable. Ankle swelling will generally persist for about 9-12 months.Is walking good after ankle surgery? ›
Early weight bearing (putting weight through your injured foot) has been shown to help increase the speed of healing. Try to walk as normally as possible fully weight bearing through the leg as this will help with your recovery.Does gabapentin help with pain after surgery? ›
Gabapentin is used widely to treat chronic pain, and has been demonstrated to be effective at treating acute post-operative pain following a variety of surgical procedures, with significant reductions in opioid consumption. Side effects are uncommon; the most likely are dizziness and sedation.How do you know if something is wrong after ankle surgery? ›
Localized, burning pain directly over the affected area may indicate too much pressure that is causing cast sores. A raised temperature may also indicate a wound infection. Calf pain accompanied by swelling and heat may be an indication of Deep Vein Thrombosis or a similar issue.Why does my ankle still hurt after 6 weeks? ›
Chronic Ankle Sprains
If pain continues for more than 4 to 6 weeks, you may have a chronic ankle sprain. Activities that tend to make an already sprained ankle worse include stepping on uneven surfaces and participating in sports that require cutting actions or rolling and twisting of the foot.
Fentanyl is a strong opioid painkiller. It's used to treat severe pain, for example during or after an operation or a serious injury, or pain from cancer. It is also used for other types of pain that you've had for a long time when weaker painkillers have stopped working. Fentanyl is available only on prescription.
Expect more pain than you had before the surgery.
During the immediate days following a procedure, it is common to have more pain than you had with the initial condition. The surgery itself is a form of trauma, unfortunately. Please be patient and prepared to take the time and rest necessary to move beyond this point.
- Stay Ahead of the Pain.
- Consider Non-Prescription Pain Medication.
- Get Enough Sleep.
- Slowly Increase Physical Activity.
- Don't Sit Too Long.
- Consider Doing What You'd Normally Do.
- Brace Your Surgery Site.
- Manage Your Stress Levels.
Yes, it is possible to elevate an injury too much. Elevation is a technique commonly used to treat many musculoskeletal injuries ranging from foot fractures to tendinitis in your knees. Elevating injuries in your legs or arms can encourage blood flow to inflamed tissue and reduce swelling.How do you get rid of nerve pain after foot surgery? ›
Physical therapy is one good way to help nerve pain after surgery. Medications including Neurontin, Lyrica, Elavil, Topomax, and Ultram can help in order to treat nerve damage after surgery and relieve pain. Orthobiologics (e.g. platelet-rich plasma — PRP) may help in this regard.How long does the burning sensation last after ankle surgery? ›
You will feel a burning sensation around the incisions when you leave your foot down for the first 2-3 days, this is normal and is you body's way of trying to tell you to keep your leg elevated. Your foot will swell quickly if allowed to be in a dependent position for any extended period of time.How painful is physical therapy after ankle surgery? ›
Your physical therapist may use tissue massage to break up scar tissue to regain joint mobility after surgery, which can cause discomfort. Exercises and stretches, deep tissue massage, and other movements you perform during physical therapy may also cause some discomfort.How long should you stay in bed after ankle surgery? ›
After a patient has fractured an ankle that then requires surgery, the recommendation is to remain in bed, with the operated leg elevated on pillows for 48 hours.Should I keep my walking boot on all day? ›
If supplied, wear the boot for comfort and use crutches when walking. It is ok to take the boot off at night, when resting at home and to wash. Regularly perform the exercises below to get your movement back.Does walking reduce ankle pain? ›
Read on for a list of suggested exercises to ease your pain. Resting your feet wherever possible by not running, walking or standing for too long can help to avoid any more inflammation. Wearing comfortable shoes with good arch support will also reduce the strain on your feet.What medicine helps ankle pain? ›
In most cases, over-the-counter pain relievers — such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) or acetaminophen (Tylenol, others) — are enough to manage the pain of a sprained ankle.
Injury to any of the ankle bones, ligaments or tendons and several types of arthritis can cause ankle pain. Common causes of ankle pain include: Achilles tendinitis. Achilles tendon rupture.Will nerve pain ever go away after surgery? ›
It is difficult to determine why some people may get nerve pain after surgery and others don't. For most, when nerve pain occurs, it usually recovers spontaneously. For others, permanent damage may happen, and no recovery is possible.How do you know when nerve pain is healing? ›
How do I know the nerve is recovering? As your nerve recovers, the area the nerve supplies may feel quite unpleasant and tingly. This may be accompanied by an electric shock sensation at the level of the growing nerve fibres; the location of this sensation should move as the nerve heals and grows.How do you get rid of nerve pain in your ankle? ›
- Icing—Icing can relieve swelling and inflammation to help the nerve heal.
- Massage—Massage can relieve compression of the nerve and help with pain.
- Anti-inflammatory medicines—Medicines available over the counter or by prescription can reduce inflammation and pain.
Swelling and numbness
You can expect this to last 6 months to 1 year depending on the type and complexity of the surgery you had, your age, weight and other medical problems. Most frequently this will resolve. Limb elevation, ice, compression socks and active range of motion can help with the symptom of swelling.
Swelling. It's normal for a sprained ankle to swell, sometimes for four to six weeks, or longer. But swelling that persists for more than three months may be a sign of trouble.How do you loosen a stiff ankle after surgery? ›
- Lie on your back with your involved leg bent and you uninvolved leg straight.
- Keep the foot of your involved leg flat on the table.
- Slowly straighten your involved leg until you cannot without your foot lifting off the table.
- Return to starting position and repeat as above.
You've had surgery to remove orthopedic hardware such as metal screws, pins, or plates. You can expect some pain and swelling around the cut (incision) the doctor made. This should get better within a few days. But it's common to have some pain for up to several weeks.
Conclusion: The incidence of late pain overlying the distal tibial and fibular plate or screws is not insignificant. Although pain is generally decreased after hardware removal, nearly half of patients continue to have pain even after hardware removal.Can you feel the screws in your ankle after surgery? ›
In most instances, these screws and plates do not create symptoms and remain permanently in the foot. However, in some patients, hardware can become prominent or irritate a nearby tendon or other soft tissues. Some patients also complain of achiness in the foot or ankle related to weather changes.
After foot surgery, any pain that lasts for more than two months is not considered a normal part of the healing process and should be evaluated by an experienced Tarrant County podiatrist to determine the cause.What is cutaneous nerve pain after ankle surgery? ›
When one or more of these nerves are damaged during a foot or ankle surgery, the patient may experience pain, numbness, or tingling in the area supplied by the injured nerve. The cutaneous nerves may become damaged when the surgeon makes an incision, or if the nerve is bruised or pinched during surgery.What does nerve damage in ankle feel like? ›
Mild peroneal nerve injuries can cause numbness, tingling, pain and weakness. More severe injuries can be characterized by a foot drop, a distinctive way of walking that results from being unable to bend or flex the foot upward at the ankle.What is the best way to sleep after ankle surgery? ›
Sleeping On Your Back
One of the best sleeping positions after any kind of surgery requires lying straight on your back.
In the days and weeks after surgery, protein is an important part of bone and tissue healing. Good sources of protein include fish, poultry, eggs, soy products, quinoa, chia seeds, spinach, lentils, nuts and beans.How long does it take to heal from broken ankle surgery plate screws? ›
They might also install metal plates, wires, or screws to keep your ankle bones stable while the bones heal. Recovery from this surgery takes at least 6 to 8 weeks.How painful is hardware removal from ankle? ›
You can expect some pain and swelling around the cut (incision) the doctor made. This should get better within a few days. But it's common to have some pain for up to several weeks.How long does it take for nerves to heal after ankle surgery? ›
Nerves typically grow about an inch per month, and once the insulating cover is repaired, the nerve will usually begin to heal three or four weeks afterwards. A nerve injury in the ankle above the toes may take up to a year to return feeling to the toes.What does it feel like when nerves are healing after surgery? ›
As your nerve recovers, the area the nerve supplies may feel quite unpleasant and tingly. This may be accompanied by an electric shock sensation at the level of the growing nerve fibres; the location of this sensation should move as the nerve heals and grows.