Why can pain persist after surgery? A guide for Veterans

Before your appointment

Pain can continue because of an ongoing physical problem, an injured nerve, changes in how the nervous system processes signals, or a combination. An examination helps your team work out which explanation fits you. VA explanation of pain types.

What does a “sensitive nervous system” mean?

Your nerves, spinal cord, and brain help detect and respond to possible harm. With persistent pain, that system can become more responsive. Signals may produce more pain than they used to, and pain can continue after the original tissues have healed.

This is one possible contributor to persistent pain. It is not something to assume from a normal scan or a long recovery alone. Your clinician still needs to assess new symptoms and other causes. NIH explanation of persistent pain.

If someone mentions “sensitization,” ask: “What makes you think that is part of my pain, and what else have we considered?” You deserve an explanation you can use.

Why might the care plan include several treatments?

Different parts of the problem may need different kinds of help. A plan might include physical therapy, pain education, medication review, or support with sleep and coping. VA describes movement-based treatment, cognitive behavioral therapy, and Whole Health among approaches used in pain care. Which ones fit depends on your condition and goals. VA pain care approaches.

If you are offered help with stress or coping, ask how it connects to your recovery. You can also ask how the team will continue to assess physical symptoms while you try it. A useful plan should make sense to you.

Make movement questions specific

After surgery, the right amount of activity depends on the operation and your restrictions. A general video cannot clear you to exercise.

Instead of asking only “Should I move more?”, try:

• “Which movements are safe for me now?”
• “How much should I start with?”
• “What symptoms mean I should stop and call?”
• “Who can adjust the plan if I keep having a flare?”

If an activity repeatedly leaves you unable to manage the rest of the day, describe that pattern to your therapist or clinician. Ask them to help you choose a starting point you can repeat.

Bring one goal to your VA appointment

Choose something that matters in your daily life: preparing a meal, sitting through a family visit, or returning to a hobby. Then explain what currently gets in the way.

For example: “I want to cook dinner again. Right now, standing at the counter is the part I cannot manage. What should we work on first?”

That question gives you and your team a concrete way to discuss treatment. Ask what improvement to look for and when you will review the plan together. If care is split between VA and a community clinician, ask which team should receive your progress update.

Your next step: Write down one question about the cause of your pain and one activity you want help returning to. Bring both to your next visit.

This guide explains pain concepts; it does not establish that your pain is caused by sensitization or replace an individual assessment.

Your next step

For help navigating services, read chronic pain care through VA and the Community Care referral checklist.

Source video

Adapted from themes in Acute Pain to Chronic Pain Pathophysiology: Christopher Gharibo, M.D., uploaded by OnlineSymposia. Relevant caption sections: 01:04–01:27 and 03:16–04:59. The supplied video is a five-minute excerpt, not the full lecture. Historical reimbursement statements and procedure-specific incidence figures were omitted. Video content was reviewed through automatic captions, not audiovisual playback.