Research Summary

Postoperative Pain in Hand Surgery Driven by Time, Not Psychological or Demographic Factors

Anthony Calabro, MA

Key Highlights

  • Postoperative pain following hand surgery was generally low across all patients.
  • Pain intensity was significantly higher on postoperative Day 1 and Day 3.
  • Psychological factors (anxiety, catastrophizing) and demographics (age, gender) did not significantly influence pain perception.
  • Emphasis should be placed on time-based pain management rather than patient-specific psychological profiling.

In a single-arm clinical trial of patients undergoing hand surgery, postoperative pain was found to be minimal and primarily influenced by timing rather than patient demographics or psychological predispositions. Pain levels peaked on Days 1 and 3 following surgery, with no meaningful associations identified between pain intensity and factors such as anxiety, pain catastrophizing, age, or gender.1

Effective pain management continues to challenge clinicians, with acute postoperative pain affecting more than 80% of the nearly 100 million surgical patients annually in the United States.2 Recent studies have highlighted the possible influence of psychosocial and demographic variables on pain perception.3 This study sought to evaluate these associations in the context of hand surgery, a common elective procedure, to better guide tailored pain control strategies.

In the current study, researchers enrolled 62 adult patients undergoing hand surgery at Mayo Clinic Florida. Before surgery, participants completed the Pain Catastrophizing Scale (PCS) and the State-Trait Anxiety Inventory (STAI) to assess psychological variables. Postoperatively, patients recorded their pain levels using a numerical rating scale (NRS, 1–10) every 4 hours for 3 days using a smartphone app. Medication usage was tracked, and statistical modeling was employed to determine predictors of pain severity.

Of the participants, 62.9% were women and the majority (90.3%) identified as White. Most patients reported low preoperative anxiety (80.6% for STAI-State; 82.3% for STAI-Trait) and low levels of pain catastrophizing (61.3%). Pain scores remained low across the 3-day period, with median values between 1.0 and 2.0. Mixed effects models demonstrated that time was a significant predictor of pain levels, with Day 1 showing the highest pain scores. Logistic regression analysis further supported time as a key factor, identifying Day 3 as another peak period for heightened pain. However, neither psychological factors nor demographic characteristics were significantly associated with pain outcomes.

“Postoperative pain after hand surgery was generally low, with time being a significant predictor of increased pain on the first and third days,” the authors concluded. “Demographic factors, anxiety, and catastrophizing did not significantly affect pain levels.”

References

  1. Borna S, Gomez-Cabello CA, Haider SA, et al. Postoperative pain in hand surgery: influence of psychological and demographic factors. Plast Reconstr Surg Glob Open. 2025;13(Suppl 1):15-16. doi:10.1097/01.GOX.0001112048.84014.c1.
  2. Speed TJ, Hanna MN, Xie A. The Personalized Pain Program: A New Transitional Perioperative Pain Care Delivery Model to Improve Surgical Recovery and Address the Opioid Crisis. Qual Manag Health Care. 2024;33(1):61-63. doi:10.1097/QMH.0000000000000450
  3. Landmark L, Sunde HF, Fors EA, et al. Associations between pain intensity, psychosocial factors, and pain-related disability in 4285 patients with chronic pain. Sci Rep. 2024;14(1):13477. Published 2024 Jun 12. doi:10.1038/s41598-024-64059-8