Christa writes in to “Ask the Doctor” to say she developed pain on her skin after surgery for a hysterectomy, which was diagnosed as “nerve pain.”  Then when she had additional abdominal surgeries, the pain seemed to spread wherever she had these follow-up procedures.  Now even if she burns her hand on the stove or gets a minor cut in the kitchen, the pain spreads.  And the original skin pain seems to have spread deeper inside.  What’s going on?

As always, I can’t make diagnoses from afar.  But some common things happen when you have chronic nerve pain:

• new pains feel worse
• newly injured places on your body can more easily develop into chronic pain sites
• pain can spread to adjoining tissues

Pain brings more pain.  It seems that when the nervous system is chronically experiencing pain, it can get stuck in a “create pain” mode.  So a new injury is likely to feel more painful than it normally would.  As well, new traumas - a major one like surgery, or even a minor one like a small cut from a kitchen knife - can more easily develop into chronic pain.  Also, pain on the skin surface, like Christa’s, can seem to go deeper, or the reverse can happen.  It seems as if pain is spreading.

The underlying problem may be “sensitization.”  One’s whole nervous system may become more sensitive and not able to handle more minor injuries.  It has been primed to experience pain.  Think about a forest that’s dry - it’s had no rain for months.  If someone drops a match or lightening strikes, a roaring fire can start in a second.  The area has been set up for this to occur easily.  Or if you’ve had a bad day at work and the traffic is horrible on the drive home, the scene has been set for an argument with your spouse at the front door.

It’s very important for your whole nervous system to calm down - like pouring water on the dry leaves of the forest, or taking some deep breaths before walking in your front door.  Pain medicine practitioners should know about sensitization and ways to treat it, including medication and de-sensitization physical therapy exercises.

Good luck, Christa.

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