Chronic Post-Surgical Pain (CPSP)

Conditions

Understanding Chronic Post-Surgical Pain (CPSP)

Chronic Post-Surgical Pain (CPSP) is pain that persists for more than three months after surgery, beyond the expected healing period. It may arise from nerve injury, scar tissue formation, inflammation, or changes in pain signalling pathways. The pain can be localised to the surgical site or radiate to surrounding areas, and it may range from mild discomfort to severe, function-limiting pain.

While many people recover fully after surgery, a small proportion develop persistent pain, particularly following procedures involving the chest, breast, abdomen, spine, pelvis, or limbs. Early recognition and expert management are key to preventing long-term nerve sensitisation and functional decline.

Typical symptoms include:

  • Ongoing aching, burning, stabbing, or tingling pain near the surgical scar
  • Sensitivity or numbness around the incision site
  • Shooting or electric-shock sensations
  • Pain triggered by movement, clothing, or light touch
  • Sleep disturbance, fatigue, or low mood due to persistent discomfort

CPSP can significantly affect quality of life, limiting mobility and confidence. Fortunately, with specialist multidisciplinary care, symptoms can often be reduced or resolved.

Wessex Pain Clinic

How We Diagnose

At Wessex Pain Clinic, diagnosis begins with a detailed medical history and physical examination, focusing on the type of surgery performed, timing of symptom onset, and characteristics of the pain.

Our consultants are looking to identify whether the pain is neuropathic (nerve-related), inflammatory, or musculoskeletal in origin — as each requires a distinct treatment approach.

We may arrange:

  • Ultrasound or MRI imaging if needed to assess scar tissue, inflammation, or nerve entrapment
  • Diagnostic nerve blocks to identify which nerves are contributing to pain
  • Collaboration with surgeons if indicated.

This careful, multidisciplinary evaluation ensures accurate diagnosis and avoids unnecessary repeat surgery.

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Lifestyle and Complementary Therapies

Our physiotherapy and rehabilitation partners focus on restoring strength, flexibility, and confidence in movement. They provide:

  • Scar and soft tissue mobilisation
  • Desensitisation and gentle stretching programmes
  • Postural correction and movement re-education

Our pain psychology partners help patients manage the emotional effects of persistent pain — addressing anxiety, trauma, and reduced confidence through Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness-based strategies.

This consultant-led, multidisciplinary approach ensures that both the physical and psychological dimensions of chronic post-surgical pain are treated effectively, allowing patients to return to normal life and activity with improved comfort. At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.

Medications

We may recommend:

  • Neuropathic pain medications such as amitriptyline, duloxetine, gabapentin, or pregabalin to calm overactive nerves
  • Anti-inflammatory medicines (NSAIDs) for residual inflammation
  • Topical treatments (lidocaine, gabapentin gel or capsaicin patches) for scar tenderness or nerve irritation
Interventional Procedures

Our consultants are experts in precision, image-guided procedures that directly target the pain source, including:

  • Local nerve blocks to reduce pain transmission around the surgical area
  • Scar infiltration with local anaesthetic and corticosteroid for hypersensitive scar tissue. We may consider botox if resistant to previous treatment.
  • Pulsed radiofrequency (PRF) treatments to modulate nerve activity and provide long-term relief
  • Lidocaine infusions for widespread or complex neuropathic pain
  • Peripheral nerve stimulation for refractory cases
  • Qutenza (high strength capsaicin patches).
Our management of chronic post-surgical pain is comprehensive, patient-centred, and multidisciplinary, combining medication, interventional treatments, rehabilitation, and psychological support.

Treatment at Wessex Pain Clinic

Treatments