---
title: "Post-Surgical Pain"
---
## Stuck Between Two Doctors Who Don't Know What to Do
If you have persistent pain after surgery, you may have spent the past months or years bouncing between providers who cannot help. Your surgeon says the surgery was successful and your imaging looks fine. Your primary care doctor is not sure what to do with surgical site pain. Pain medications dull the edge but do not address what is actually happening. Meanwhile, you are living with pain that was not supposed to be there.
This is one of the most common situations we see at PHI. Patients who had surgery for a specific problem develop persistent pain at or near the surgical site that does not fit anyone's standard treatment algorithm. The pain is real, it has specific biological causes, and it usually responds to specific treatments that target what is actually happening rather than another round of medication or another imaging study.
## What Causes Persistent Pain After Surgery
A small but significant percentage of surgical patients develop persistent pain after their procedure, even when the surgery was technically successful. The medical literature calls this persistent post-surgical pain, and it is increasingly recognized as a real and treatable clinical entity.
Common causes include nerve injury from the surgery itself (from cutting, retraction, or scar formation), nervous system sensitization (when pain signals continue long enough that the nervous system maintains pain even after the tissue has healed), scar tissue irritating nearby nerves, persistent inflammation, and mechanical changes (lumbar fusion changes how forces transfer through the lower spine; knee replacement changes how the leg and hip function), which can produce pain in adjacent structures even when the surgery itself was successful. Sometimes there is a specific identifiable cause not recognized earlier, such as hardware loosening or recurrent disc herniation. The first step in treatment is identifying which of these is contributing.
## Common Patterns We Treat
After back surgery, failed back surgery syndrome and post-surgical SI joint pain are common; lumbar fusion changes how forces transfer through the lower spine, which often produces new SI joint pain months or years later. After joint replacement, persistent post-arthroplasty pain may involve nerve injury or mechanical issues, and genicular nerve blocks and radiofrequency ablation can be particularly helpful for persistent post-knee-replacement pain. After hernia or abdominal surgery, persistent pain near the site often involves nerve injury. After mastectomy or chest surgery, post-mastectomy pain syndrome can develop. After trauma surgery and cancer-related surgery, persistent pain related to nerve damage is increasingly recognized and treated, and we coordinate with oncology teams when appropriate.
## How PHI Treats Post-Surgical Pain
The first step is comprehensive evaluation: the surgery you had and the original problem it addressed, the character and pattern of your pain, your prior imaging and treatment history, whether specific identifiable causes need further evaluation, and the nervous system component.
Targeted nerve blocks can both diagnose and treat nerve-mediated pain; a successful diagnostic block confirms the specific nerve involved, and many patients experience meaningful relief from the block itself. Radiofrequency ablation of specific nerves can provide longer-lasting relief, particularly for persistent post-knee-replacement pain and certain post-spine-surgery patterns. Peripheral nerve stimulation is often particularly appropriate because post-surgical pain typically has a focal nerve distribution; PHI offers the 60-day Sprint temporary system, FDA-cleared for post-surgical pain. PRP therapy may be appropriate for selected patients with tendon, ligament, or soft tissue components. PHI performs these procedures in our affiliated QUAD A-accredited surgery center and coordinates with surgical specialists when surgical re-evaluation genuinely makes sense.
## When to See Someone
Consider professional evaluation when pain at or near a surgical site has persisted longer than expected (typically more than three to six months post-surgery), when it is interfering with sleep, daily life, or recovery, when your surgeon has confirmed the surgery itself was successful and imaging looks normal, when you feel stuck between providers without a clear plan, or when standard pain medications are providing limited relief.
Seek prompt evaluation for new onset of severe pain at the surgical site, signs of infection (redness, swelling, warmth, fever), or sudden new neurological symptoms such as significant weakness or changes in bladder or bowel function. These can indicate problems requiring urgent surgical evaluation.
## Why PHI for Post-Surgical Pain
## Frequently Asked Questions
**Q: Why do some patients develop persistent pain after surgery and others don't?**
This is not fully understood, but research has identified risk factors including the type of surgery, severity of pre-surgical pain, and individual nervous system characteristics. Persistent post-surgical pain develops in a small but real percentage of patients regardless of how well the surgery was performed; it is not generally a sign of surgical error.
**Q: Should I get a second opinion on my surgery?**
Possibly, depending on your situation. If your imaging shows specific issues such as hardware loosening or recurrent problems, surgical re-evaluation makes sense. If imaging is normal and the pain is consistent with nerve-mediated post-surgical pain, additional surgery is often not the answer. Your physician can help you understand whether further surgical evaluation is appropriate.
**Q: Will my post-surgical pain go away on its own?**
This varies significantly. Some resolves over months as healing progresses; some persists indefinitely without treatment. Earlier treatment often produces better outcomes than waiting, because the longer pain persists, the more nervous system sensitization can develop.
**Q: How effective is peripheral nerve stimulation for post-surgical pain?**
Clinical trials have shown meaningful pain reduction, with the 60-day temporary system specifically demonstrating sustained benefit beyond the active stimulation period for many patients. PNS is one of the most evidence-supported treatments for nerve-mediated post-surgical pain.
**Q: What if I don't want any more procedures?**
The treatments we offer are minimally invasive and generally well-tolerated. Nerve blocks involve injection only. Radiofrequency ablation is a needle procedure under sedation. Peripheral nerve stimulation involves placement of a small lead, sometimes through a temporary system removed after 60 days. We discuss all options thoroughly so you can decide what feels right.
**Q: Will I need to be on pain medication forever?**
Many patients can reduce or eliminate the need for chronic pain medications when interventional treatments address the underlying source. The goal is the right level of medication for your specific situation.
**Q: What if my situation involves cancer surgery?**
PHI treats post-cancer-surgery pain such as post-mastectomy and post-thoracotomy pain and coordinates with oncology teams when appropriate. Persistent pain after cancer surgery is increasingly recognized as a treatable condition rather than something patients should expect to live with.
**Q: How is this different from my surgeon's follow-up care?**
Surgeons typically focus on whether the surgery itself was successful and the original problem addressed. They are often less equipped to evaluate persistent pain after a successful surgery, particularly when imaging looks normal. Interventional pain physicians specialize in identifying and treating these specific patterns.
**Q: Do you take insurance?**
Insurance coverage and payment options may vary. We provide documentation for you to seek reimbursement through your out-of-network benefits, which may apply to certain services. All pricing is disclosed at consultation.
**Q: Do you accept international patients?**
Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations.
## Treatments We Offer for Post-Surgical Pain
PHI offers evidence-based treatments for post-surgical pain. Your physician will recommend the right option, or combination, based on the type of surgery you had, the pattern of your pain, and your prior treatment history.
- Nerve Blocks, diagnostic and therapeutic
- Radiofrequency Ablation, including genicular ablation for post-knee-replacement pain
- Peripheral Nerve Stimulation, the 60-day Sprint temporary system
- PRP Therapy, for tendon
> Consensus guidelines for the use of peripheral nerve stimulation in the treatment of chronic pain: a Neuron Project from the American Society of Pain and Neuroscience. Peer-reviewed via PMC.
— [Latif U, et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC12614495/)
> Peripheral nerve stimulation for chronic pain: a systematic review of effectiveness and safety. Pain and Therapy, 2021.
— [Helm S, et al.](https://pubmed.ncbi.nlm.nih.gov/34478120/)
## Schedule Your Post-Surgical Pain Consultation
A 60-minute consultation will evaluate your specific situation, identify what may be causing your persistent pain, and walk through the treatment options that match it. Call (310) 856-9488 or book online now.
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