Managing Pain After Hernia Repair Surgery

Abdominal pain after hernia surgery is caused by injury to your skin, muscles and nerves during the operation. The extent and location of the surgery may affect how much pain you have afterwards, but a certain amount is to be expected.

Our goal is to keep your pain at a tolerable level that allows you to move around, eat and breathe easily, and heal more quickly. If your pain is not well controlled, tell your care team so they can adjust your medication appropriately.

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How Pain Can Affect Your Recovery

Sleep. Pain can interfere with your ability to get enough sleep and reduce energy levels. Therefore, if you have too much post-surgery hernia pain you may not have the energy to do the things that will help you heal faster, like sitting in a chair or walking.

Breathing. Pain can cause you to breathe too shallowly and may prevent you from coughing. This can lead to pneumonia.

Appetite. Abdominal pain after hernia surgery can affect your appetite. Good nutrition is very important in helping you heal well and to keep your bowels working normally.

Mood. Pain can negatively affect your mood and your relationships with others. This may affect your post-operative experience, as well as those helping you during recovery from surgery.

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How We Evaluate Pain After Hernia Surgery

Your caregivers will ask many of the following questions throughout your recovery to help us learn more about your abdominal pain after surgery. Your answers to these questions will help us identify effective ways to bring your pain under control.

• Where does it hurt? Is the pain just in your incision or does it move from one area to another?
• How would you rate your pain on a scale of 1 to 10, with 0 meaning no pain and 10 being the worst pain you've ever experienced? What number do you consider tolerable?
• How would you describe your pain? Is it sharp, cramping, twisting, squeezing or crushing? Or is it stabbing, burning, dull, numb or a “pins and needles” feeling?
• When did the pain start? Did it begin quickly or slowly? Is it steady or does it come and go?
• Does your pain wake you from sleep?
• Do certain activities like coughing cause the pain or make it worse?
• Does the pain come before, during or after meals?
• Does anything lessen the pain like changing positions, resting, medication or diet changes?

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Hernia Pain Medicine Options

Keep a written list of what medicines you take and bring the list to your appointments. Learn why you take each medication and, if you don’t know, please ask for information. Do not take any medications (over-the-counter or prescribed) without first talking to us.

Always take your medicine as directed. Call the office if you think your medicines are not helping or if you feel you are having side effects. Do not stop taking it until you discuss it with your care team. Medications we may recommend after your hernia operation include:

Pain relief medications. In the first few days after surgery, we may prescribe narcotic pain medications to keep your pain levels tolerable. As soon as possible, you will be switched to non-narcotic NSAIDs like ibuprofen which reduce inflammation and pain. We will often prescribe multiple medications that work to control pain in different, complementary ways.

Be sure to take your pain medication(s) exactly as directed. Taking more than prescribed or more often than directed can be dangerous and potentially life-threatening. Do not drive, use heavy equipment or drink alcohol while taking narcotic pain medications.

Sometimes the pain is worse when you wake up in the morning. This may happen if you didn’t have enough pain medicine in your bloodstream to last through the night. If this occurs regularly, let us know and we may recommend that you take a dose of pain medicine during the night or right before bed.

Do not stop taking pain medicine suddenly if you have been taking it longer than 2 weeks. Your body may have become used to the medicine. Stopping the medicine all at once may cause unpleasant or dangerous side effects. Ask for help in weaning off the medications.

Pain medications may not get rid of pain completely. The goal is to keep pain at a level that allows you to move around, eat and breathe easily. Do not wait until your pain level is intolerable to ask for medicine.

Anti-nausea medications. Pain medicine may upset your stomach and make you feel like vomiting. Because of this, pain medicine and anti-nausea medicine are often given at the same time. This medicine may be given to calm your stomach and control vomiting.

Anti-anxiety medicine. If you have anxiety, it is important to let us know because reducing anxiety levels can help lessen pain.

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Hernia Pain Control Techniques

Pain control techniques help you deal with pain instead of taking it away. It’s important to practice the techniques even when you don’t have pain, if possible. This will help the techniques be more effective during an episode of pain. Techniques include:

Activity. In the first few days after surgery, you may need to rest in bed with your upper body raised on pillows. However, as soon as you are able, it is important to start moving around. Movement improves breathing and digestion and helps you heal faster. At first, it may be uncomfortable, but moving and being active will help reduce abdominal pain over time. In addition, moving your legs often while resting in bed or sitting in a chair can help prevent blood clots from forming.

Cold and Heat. Both cold and heat can help reduce some types of post-operative pain. Some types of pain improve best using cold while other types of pain improve most with heat. Caregivers will tell you if cold and/or hot packs will help your abdominal pain after hernia surgery.

Use a Pillow. Holding a pillow firmly against your incision(s) can help reduce pain, especially when coughing or sneezing.

Distraction. Focus your attention on something other than the pain. Playing cards or games, talking and visiting with family, watching TV or reading may relax you and distract you from thinking about your hernia pain.

Music. Listen to music, sing, hum or play an instrument. Music increases blood flow to the brain, improves energy and helps change your mood. Music may also trigger your brain to release endorphins which help you feel better.

Relaxation Techniques. Stress and anxiety can make pain worse and may slow healing. Since it’s difficult to avoid stress, learn to manage it. Ask for more information on deep breathing exercises, muscle relaxation techniques or meditation.

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Enlist a Support Person to Help

Plan to have a trusted friend or family member with you at all times during the immediate post-surgery period. Your support person can help keep you comfortable by:

• Providing more pillows or blankets if you need them.
• Adjusting the room temperature when necessary.
• Rubbing your back to help you relax and lessen your pain.
• Putting a cool cloth on your hands or face.
• Keeping the lights and noise in your room as low as possible while you are resting.

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Tips for Managing Medication Side Effects

Pain medications can sometimes have unpleasant side effects like nausea and constipation. If nausea is a problem, try taking your medication with food, such as a few crackers.

Constipation while taking narcotic pain medications is very common. It’s important not to strain and try to push out a bowel movement if the stool is too hard – this can make your pain worse. Instead, try the following tips to help keep stools soft and your bowels moving:

• Avoid hard cheeses and refined grains, such as rice and macaroni. Eat more foods high in fiber like raw fruits and vegetables, whole-grain breads and cereals, dried fruits, popcorn and nuts.
• Talk to your caregiver about drinking more liquids if you are not on a fluid restriction. Drinking warm or hot liquids can help make your bowels more active. Prune juice may also help to soften stool.
• Walking is a very good way to get your bowels moving. Start gradually and do a little more each day. Try to get up and around and do as much of your own personal care as possible.

If side effects continue or worsen, let us know. You may need additional/different medications.

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When to Contact Your Care Team

Call your surgeon's office if any of the following occur:

• You still have pain one hour after taking your pain medication (it may not be strong enough).
• You feel too sleepy or groggy (your pain medication may be too strong).
• Nausea and vomiting persist despite taking medications with food.
• You develop a rash, which may be a side effect of the medicine you are taking.
• You are worried or have questions about your pain.

If pain persists longer than three months, your care team may suggest that you go to a pain clinic. The specially trained providers at the clinic can teach you strategies to control the pain along with medication. Some of these methods are relaxation therapy, hypnosis and acupuncture.