Trunk pain can follow any trauma or surgery. Many different interventions are performed on the abdomen, chest and trunk by orthopedic, vascular, thoracic, cardiac, gynecologic, general and plastic surgeons. Despite the fact that these treatments can all successfully address the original medical problem, a small number of patients can be left with new, nerve related problems. This usually presents as a chronic and localized pain that persists beyond expected the recovery time. From this point, a numbers of pain treatments are offered to patients by many specialists. Since the vast majority is focused on treating patient symptoms, solution is seldom found. Unlike other specialties, peripheral nerve surgery is aimed towards the anatomical cause of the chronic pain, ensuring best possible chance for the cure.
You should see Dr. Ducic for chronic trunk pain if your symptoms persist:
- After common reasons for prolonged post-operative pain (infection, bleeding, tumor, intestinal, gynecologic, pulmonary, and others) have been excluded by your initial surgeon or treating sub-specialist
- Despite the medical care prescribed to you by your surgeon or other specialist
- Despite supportive care, such as activity and work adjustments, negative radiological work-up
- After six months of prescribed medical and conservative care
Patients with chronic trunk pain may report pins and needles or burning sensation over involved trunk area (abdominal wall, chest, back). Scars from previous surgery may be hypersensitive or painful. Daily activities can be adversely affected. Symptoms may be preset at rest and exacerbated by activity. The extent of this presentation may vary, depending on severity and etiology of injury, number of nerves involved and intensity of pain. Failure to intervene in timely manner, poses a risk for chronic pain to evolve into a more complex disorder involving of your central and autonomic nervous systems, making treatment more challenging and difficult. Therefore, peripheral nerve surgery has an important role in treating chronic trunk pain, giving patients a chance to eliminate dependence on pain medications and improve their quality of life. Based on patient’s presentation and findings on physical exam, the involved sensory nerves are surgically removed so they would not continue to generate pain.
During surgery for chronic trunk pain:
- You receive anesthesia so you won’t feel any pain during the surgery.
- Incision is made over involved trunk area(s) to access and remove damaged painful nerves. This can be done through old scar or might require new access site.
- In most cases, involved nerves are primarily sensory nerves, so no motor deficits are expected. The skin is closed in anatomical layers.
- Ambulation is allowed immediately after surgery, as tolerated.
- Peripheral nerve surgery for chronic trunk pain is usually an outpatient procedure; your dressing will be removed about 3-5 days after surgery, while sutures are removed about two-three weeks later.
If you are not sure about your eligibility for surgery, and if you are not in the Washington, D.C. area, you can send me your records so I can determine if you are a good candidate for treatment. Visit my patient forms page for a downloadable form.