Chronic post-surgical pain (CPSP) is one of the most common and serious complications after surgery. Peripheral and central nervous systems change in response to repetitive nociceptive stimulation. This includes risk factors being identified pre-, intra-, and postoperative. There is no universally agreed upon definition of CPSP, though the working definition above is commonly used. CPSP is associated with several detriments including an increased use of analgesic use, restriction of daily life activities, significant effects on quality of life, and an increased use of health care services. In the UK alone 4 million people undergo surgery every year, so CPSP poses not only a problem for the patients, but also a serious economic and health care burden.
The main problem with the research regarding CPSP is that not all studies are consistent about the incidence occurring. There are wide variations between different surgical procedures leaving a lack of consistency on the topic. Some of this can be attested to the lack of clarity on a specific definition of CPSP. Other issues have been small sample sizes, poor questionnaire response rates, and selection bias. As of 2008 CPSP had only been recognized as a significant problem over the previous 10 years. The first paper on CPSP was published by the British Journal of Anesthesia, stating there is a need for education on the topic for the medical profession, as well as the general public, so that effective measures are introduced and unnecessary, inappropriate operations are minimized.
In the years since there have been several review articles written and other studies conducted regarding CPSP, including a recent study in the British Medical Journal where the authors state ‘chronic pain is the most common and serious long term problem after repair of an inguinal hernia. Another study conducted by Kelly Armstrong aimed to find sufficient evidence supported the application of MPS therapy to such surgical scars in association with CPSP.
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