August 2018

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Guide to scar pain

Posterior neck pain of scarring origin

We will first recall the notion of cicatricial neuropathy. These pains are neuropathic pains. The causes of posterior neck pain of scarring origin are (non-exhaustive): Brain surgery: Open surgery (trephination) Stereotaxic surgery (doctor’s version) Intraoperative

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Guide to Scar Pain

Posterior neck pain of scarring origin

We will first recall the notion of cicatricial neuropathy. These pains are neuropathic pains. The causes of posterior neck pain of scarring origin are (non-exhaustive): Brain surgery: Open surgery (trephination) Stereotaxic surgery Intraoperative head fixation

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Anterior neck pain

Anterior neck pain of scarring origin

We will first recall the notion of cicatricial neuropathy. The causes of anterior cervical pain of scarring origin are (non-exhaustive): Cervical spine surgery: Anterior approach Intraoperative head fixation system Thyroid and parathyroid surgery Cervical lymph

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Anterior neck pain

Anterior neck pain of scarring origin

We will first recall the notion of cicatricial neuropathy. The causes of anterior cervical pain of scarring origin are (non-exhaustive): Cervical spine surgery: Anterior approach Intraoperative head fixation system Thyroid and parathyroid surgery Cervical lymph

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Anterior head pain

Facial pain caused by scarring

We will first recall the notion of cicatricial neuropathy. The causes of anterior headaches of cicatricial origin are (non-exhaustive): Brain surgery: Open surgery (trephination) Stereotaxic surgery (doctor) Intraoperative head fixation system (doctor) Scalp and forehead

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Anterior pain of the head

Facial pain caused by scarring

We will first recall the notion of cicatricial neuropathy. The causes of anterior headaches of cicatricial origin are (non-exhaustive): Brain surgery: Open surgery (trephination) Stereotaxic surgery (doctor) Intraoperative head fixation system (doctor) Scalp and forehead

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Anterior chest pain

Placement or removal of an implantable port (SIEV)

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description 3 approaches to the central venous network are possible, the puncture area can be the cause of

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Anterior chest pain

Placement or removal of an implantable port (SIEV)

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description 3 approaches to the central venous network are possible, the puncture area can be the cause of

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Anterior head pain

Anterior head pain of scar origin

We will first recall the notion of cicatricial neuropathy. The causes of anterior headaches of cicatricial origin are (non-exhaustive): Brain surgery: Open surgery (trephination) Stereotaxic surgery (doctor) Intraoperative head fixation system (doctor) Scalp and forehead

Read more

Anterior pain of the head

Anterior head pain of scar origin

We will first recall the notion of cicatricial neuropathy. The causes of anterior headaches of cicatricial origin are (non-exhaustive): Brain surgery: Open surgery (trephination) Stereotaxic surgery (doctor) Intraoperative head fixation system (doctor) Scalp and forehead

Read more

Guide to scar pain

Posterior pain of the head of scar origin

We will first recall the notion of cicatricial neuropathy. The causes of posterior pain of the head of scarring origin are (non-exhaustive): Brain surgery: Open surgery (trephination) Stereotaxic surgery (doctor subscription) Intraoperative head fixation system

Read more

Anterior neck pain

Chronic pain after cervical spine surgery by anterior approach

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Anterior cervical spine surgery is done through an anterior and lateral incision in the midline of the

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Anterior neck pain

Chronic pain after cervical lymph node dissection

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description Cervical lymph node dissections can be responsible for neuropathic pain in the neck, face and head: The

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Guide to Scar Pain

Infiltration of the lumbar spine, rhizolysis MEDECIN

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description A few cases of lumbar pain, radiating into the lower limb, with a neuropathic appearance appear after

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Guide to scar pain

Infiltration of the lumbar spine, rhizolysis

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description A few cases of lumbar pain, radiating into the lower limb, with a neuropathic appearance appear after

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Guide to scar pain

Obstetric or other epidural

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description The realization of an epidural for the childbirth is done by lumbar way in general in L3-L4

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Guide to scar pain

Posterior lumbar spine surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Different types of lumbar spine surgery are offered: Endoscopic surgery for herniated disc (minimally invasive surgery). Open

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Guide to scar pain

Wound, hematoma, burn in the lumbar region

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Whether wounds, hematomas or burns, the healing phase can cause neuropathic pain. The pain can then extend

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Guide to scar pain

Wound, hematoma, chest burn

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description Wounds and burns can lead to the formation of cutaneous and subcutaneous fibrous areas responsible for neuropathic

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Fibromyalgia

Diffuse Cicatricial Hyperesthesia Syndrome (CDHS) MEDECIN

This new clinical entity is found in a few patients with chronic pain. Définition   Cicatricial neuropathy affecting all of the scars found in a patient. Its current incidence is not known. There is probably

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Ankle and foot pain

Wound, burn, hematoma of the ankle and/or foot

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Wounds and burns of the ankle and foot give visible scars and behave like surgical scars giving

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Ankle and foot pain

Foot surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description The different foot surgeries correct big toe problems (hallux valgus, hallux rigidus, ingrown toenail), metatarsal pain, Morton’s

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Ankle and foot pain

Ankle surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description The ankle can be operated for disabling osteoarthritis, severe sprains, instability, fracture. The interventions are, depending on

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Ankle and foot pain

Wound, hematoma, leg burn

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Wounds and burns of the leg give visible scars and behave like surgical scars giving neuropathic pain

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Guide to scar pain

Wound, hematoma, knee burn

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description Wounds and burns of the knee give visible scars and behave like surgical scars giving neuropathic pain

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Guide to scar pain

Bone graft harvesting from the iliac crest

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Some orthopedic surgeries require the implantation of a bone graft. This is taken (often) from the iliac

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Guide to scar pain

Wound, hematoma, thigh burn

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description Wounds and burns can lead to the formation of cutaneous and subcutaneous fibrous areas responsible for neuropathic

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Guide to scar pain

Open femoral artery surgery or angioplasty by femoral approach

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description For open surgery, the incision depends on the part of the artery to be treated: For angioplasties

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Guide to scar pain

Varicose vein surgeries

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Anatomical reminder: The internal and external saphenous veins allow the venous return of the lower limb for approximately

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Guide to scar pain

Femur surgery (particularly fracture)

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description Femur surgery is basically a femoral shaft fracture treatment surgery. The type of intervention depends on the

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Guide to scar pain

Hip surgery (prosthesis, abutment, etc.)

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description There are two main approaches in hip surgery: a lateral approach and an anterior approach. Each of

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Guide to scar pain

Pudendal nerve surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description There are different surgical approaches to free the pudendal nerve in its entirety: The transgluteal pathway or

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Guide to scar pain

Testicular surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Testicular surgery is generally done by 3 types first: We will take advantage of this chapter to

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Guide to scar pain

Urinary incontinence surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Surgical technique Use in case of failure of perineal and sphincter rehabilitation. Several surgical techniques have been

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Guide to scar pain

Promontofixation for cure of cystocele and/or rectocele

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description The main painful complications of this surgery partly resemble the pain found in the article on pain

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Guide to scar pain

Episiotomy, bartholinitis

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description The surgical approaches to these two procedures are vulvar for bartholinitis +/- perineal for episiotomy. We will

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Abdominal pain

Wound, hematoma, abdominal burn

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description Whether wounds, hematomas or burns, the healing phase can cause neuropathic pain. The pain can then extend

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Abdominal pain

Abdominoplasty surgery, surgical liposuction

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Like all surgeries, cosmetic surgery can be responsible for chronic pain. Abdominal liposuction rarely gives pain but

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Abdominal pain

Pubalgia surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description Surgical technique The approach is located above the inguinal ligament Induced pain: The neuropathic pain induced by

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Abdominal pain

Open or laparoscopic or robotic prostate surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description Open prostate surgery is done through a horizontal or vertical incision: Laparoscopic surgery is done by 5

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Guide to scar pain

Gynecological surgery by laparoscopy

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description Like all laparoscopies, surgical trocar routes can be responsible for neuropathic pain. In gynecological surgery, most routes

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Guide to scar pain

Open gynecological surgery or caesarean section

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description This surgery is performed by a more or less wide horizontal suprapubic incision (in green). It can

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Abdominal pain

Open or laparoscopic inguinal hernia surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies Description This surgery is responsible for neuropathic pain in the territory of 3 different nerves of D12-L1-L2 origin.

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Abdominal pain

Anterior lumbar spine surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description This approach allows direct work on the vertebral body and the disc. It is responsible for certain

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Abdominal pain

Abdominal aorta, iliac and femoral artery surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description There are different approaches to perform abdominal aortic surgery: Peritoneal approaches: Extraperitoneal approaches: Chronic postoperative pain of

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Abdominal pain

Kidney or ureteral or adrenal surgery by laparoscopic route

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Laparoscopic retroperitoneal surgery is done through lateral incisions between the ribs above and the iliac crest below.

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Abdominal pain

Open renal, ureteral or adrenal surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Open retroperitoneal surgery is performed by a horizontal and lateral incision between the ribs above and the

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Abdominal pain

Laparoscopic abdominal surgery (Stomach, small intestine, colon, gallbladder, pancreas, liver, spleen, etc.)

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Like all laparoscopies, surgical trocar routes can be responsible for neuropathic pain. In abdominal surgery, the paths

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Abdominal pain

Open abdominal surgery (Stomach, small intestine, colon, gallbladder, pancreas, liver, spleen)

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Open abdominal surgery includes different routes dictated by the underlying surgery to be performed. The neuropathic pains

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Guide to scar pain

Hand surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Hand surgery has two major components: Reconstructive surgery: wound, section, carpal or finger fracture, serious sprain of

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Guide to scar pain

Wrist surgery

Reminder Explain chronic pain Cicatricial neuropathies Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies. Description Wrist surgery includes: Tendon and nerve repair surgery Treatment of wrist fractures Wrist or carpal osteoarthritis surgery

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Post operative chronic pain