It is not always possible to prevent pain during or after an operation. Although some discomfort may be inevitable, a doctor will work with other specialists, such as an anesthesiologist, to manage a person’s pain.

It is essential to remember that everyone is different. Some people may find a particular surgery very painful, while others do not. For this reason, it is difficult to rank surgeries from most to least painful.

If many people report feeling pain from one type of operation, it might be considered a particularly painful surgery.

Major surgery is not always more painful than a minor operation, which may be due to the type and amount of pain medication given to an individual.

A person should speak to their doctor and ask plenty of questions when considering surgery. A doctor can help ease their concerns about pain and recommend ways to reduce post-surgery discomfort.

Knowing which surgeries are considered particularly painful can help a person know what to expect. But this is only a guide because of the way individuals feel pain.

Most painful surgeries

Surgeons working in dark operating theatre
Surgeries involving the bones tend to cause more pain than other types.

In general, research has found that orthopedic surgeries, or those involving bones, are the most painful.

However, researchers also found that some minor surgeries or those classed as keyhole or laparoscopic could also cause significant pain.

Regardless of the type of surgery, a person should speak to a doctor about the procedure and a plan to manage any discomfort.

It is also helpful to relate any past experiences with pain medications, as some people are more or less sensitive to these drugs.

Here, we outline what are considered to be five of the most painful surgeries:

1. Open surgery on the heel bone

If a person fractures their heel bone, they may need surgery. An operation is not always necessary if the bone has not moved too far out of place.

To repair the fracture, a surgeon must cut into the skin to get to the broken bone. They can then fix the bone back together, using plates or screws.

The skin around the heel is thin, and this area does not have a lot of soft tissue. It is easy to damage the nerves around the heel bone during surgery. Along with the attachment of screws to the bone, this can make the operation and recovery painful.

2. Spinal fusion

The bones that make up the spine are known as vertebrae. Scoliosis and degenerative disc disease are among the medical problems that may affect the vertebrae.

If movement between vertebrae is causing pain, a doctor may recommend spinal fusion surgery. This process connects two or more vertebrae to stop them moving against each other.

Sometimes, surgery will involve a bone graft. This is when bone is taken from the hip and put into the spine to help the vertebrae fuse together.

Bone grafts may cause significant and even chronic pain following surgery.

3. Myomectomy

Woman facing doctor over desk.
A myomectomy may be required to remove large fibroids from the uterus.

A myomectomy is an operation to remove fibroids from the uterus. Although these muscle fibers are almost always harmless, they can be a cause of infertility.

The operation is usually done using keyhole surgery. Open surgery may be needed if the fibroids are large. An open surgery procedure is usually more painful than keyhole surgery and will have a longer recovery time.

During a myomectomy, a surgeon will cut into the belly and remove the fibroids. Once they have removed the fibroids, they will close the cut with stitches.

4. Proctocolectomy

This surgery removes the large intestine, rectum, and anal canal. Together, these make up the lowest part of the gut.

Proctocolectomy can be used to treat ulcerative colitis, bowel cancer, and some forms of Crohn’s disease.

If possible, the surgery will be done using a keyhole procedure. If this is not appropriate, surgeons will use open surgery.

5. Complex spinal reconstruction

Complex spinal reconstruction refers to several medical procedures used to treat spinal damage or disorders. These include spinal stenosis and scoliosis.

A surgeon will use metal rods and screws to correct a curved spine or make the spine stable. The spine has a high concentration of nerves and nerve endings, potentially making this surgery very painful.

Recovery

man recovering from surgery in hospital bed with male visitor.
Recovery will differ, depending on the type of surgery and the individual.

Recovery varies depending on the operation. Even people having the same operation may experience recovery differently.

A doctor can give person-specific advice on how to manage pain after their operation. They may also prescribe pain medications and give someone tips on how to make their recovery easier.

Pain after an operation is not always preventable. While opioid narcotics are often good pain relievers, they may have some negative side effects, ranging from depression to breathing difficulties.

A doctor will monitor and adjust the dose to achieve a good balance of pain control while avoiding adverse effects. There is a wide range of pain medication available to help a person cope, including:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or acetaminophen for mild to moderate pain
  • opioids, such as morphine, for moderate or severe pain

For some procedures, an epidural or peripheral nerve block catheter may be used to continuously infuse medication into the body that causes numbness for up to 4 days.

A person should tell their doctor, as soon as possible, about any uncontrolled pain that they are having. Pain medication may not work immediately, so getting pain relief immediately can help prevent it from getting worse.

Pain medication should make a person feel more comfortable and better able to move around, which can help with a good recovery.

After most surgeries, doctors recommend that a person eats, drinks, and moves around as soon as possible. If needed, a physical therapist can give person-specific exercises to help them recover.

Outlook

Everyone feels pain differently, including after different types of surgery. While some discomfort is unavoidable, a clear pain management plan and talking to medical carers about its effectiveness will help someone have a smooth recovery.