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NIS

Pain Flares and Its Management

Patients in recovery from their mesh pain after mesh removal can trigger a flare by over exertion or emotional stress. The following is a description of this by one patient and how he recovered:

"After mesh was removed pain was gone after 3 months but then I lifted a heavy dresser at 6 months and was in pain all over again. Dr. Peterson had me go and get checked for reoccurrence of hernia. That doctor said I did not have a hernia and repair felt very strong. Dr. Peterson told me I re-awoken my nerves and it may take a year to calm down and to bike and swim. I road biked a lot and did my old therapy exercises. The pain slowly reduced and took about a year for my pain to disappear again. The last two years or so I have been completely pain free as long as I do not lift anything heavy or stretch my legs far apart. Most days I don't even think about it or feel anything and I mountain bike 3 days a week for around 50 miles total every week. My life is wonderful again. I do all my PT exercises a few times a week just to keep limber because I have noticed that when I am not as active especially in winter I feel a level 1 or 2 pain when I start my activity up again."

I love this comment from this patient. He got better initially and then hurt himself. His pain came back but he did not freak out. He accepted my explanation and followed my instructions. He was patient, careful and diligent in rehabilitating himself. He has learned what his limitations are and accepts them. He recovered and now says that his life is great. His is a great story which I think should be an inspiration to all patients having a difficult recovery after hernia mesh removal.

Central pain sensitization is a prominent feature of chronic mesh pain. After mesh removal it can disappear or go into a dormant state. Central pain sensitization in a dormant state can be retriggered by over exertion or emotional arousal. This is why in my mesh pain recovery protocol I advise patients to slowly and carefully advance their exertion and length of exertion carefully and in baby steps and I advise patients to avoid and control negativity. It is easier to recover from a small flare.