Patient-Reported Gaps in Post-Surgical Pain Control: Findings From a National Survey
In a cross-sectional, observational survey of 323 U.S. patients conducted 30 to 90 days post-surgery, researchers found that 37.8% of all respondents self-identified as having inadequately managed acute post-surgical pain during the first month after surgery. Among this subgroup, the average pain score at 4 weeks post-surgery was 6.3 on the 11-point Numeric Pain Rating Scale—indicative of severe pain. The study was presented at the American Academy of Pain Medicine PainConnect 2025 annual meeting in Austin, TX.
The researchers sought to quantify patient-reported experiences with acute post-surgical pain and its broader impacts on recovery. The most common surgeries were breast reconstruction, total knee arthroplasty, and cholecystectomy, with a nearly even split between inpatient and ambulatory surgical settings.
All patients in the study received at least one prescription for pain medication, with 96.3% receiving opioids and 58.5% treated using a combination of opioids and non-opioid agents such as NSAIDs or gabapentinoids. However, 87% of patients reported side effects—most commonly constipation, drowsiness, dizziness, and nausea.
Many patients continued to experience significant pain, side effects, and functional disruption. Nearly 60% rated their pain medications as only “fair” or “poor,” and 70.1% experienced breakthrough pain between doses, often managed by using over-the-counter medications, hot/cold therapy, or taking their next opioid dose earlier than prescribed. Nearly half of all patients reported delayed return to regular activities, while 38.1% stated their pain was not well managed after hospital discharge. Among those undergoing physical therapy, 48.8% said their pain hindered their rehabilitation. For patients returning to work or school, 25% reported that pain interfered with productivity, with an average of 21.7 days of work/school lost in the subgroup with inadequately managed pain.
Patient hesitancy to take pain medications, particularly opioids (25.5%) and gabapentinoids (13.9%), further complicated treatment. These concerns were predominantly rooted in fear of side effects and addiction, highlighting a disconnect between clinical intent and patient comfort with available therapies.
“These findings highlight challenges with acute pain management therapies, including use of opioids, and consequences of inadequately managed acute pain, underscoring the need for improved acute pain management options,” the authors concluded.
Reference
Dasa V, Shi L, Garcia E, Crowder LA, Feld AJ, Asiedu N, Menzie AM. Quantifying patient perceptions of post-surgical acute pain management, including inadequately managed pain, in the United States. Presented at: PainConnect 2025, American Academy of Pain Medicine Annual Meeting; April 3-6, 2025; Austin, TX. Sponsored by Vertex Pharmaceuticals Inc.