[36F] Experiencing postoperative swelling, stiffness, and nerve pain

Patient Description

A 36-year-old female is reporting symptoms of full body pain, slight swelling, stiffness, discomfort, and nerve pain, which began 3 days ago. The patient is 5 weeks post supracervical hysterectomy and notes that the legs have become very heavy with visible swelling, now also affecting the belly and arms. The swelling is described as uncomfortable, with a sensation of pressure. The patient's muscles feel tight and lumpy, with stiffness being more pronounced in the legs and arms. Heat application provides some relief. The patient rates the full body pain and nerve pain as 6/10, with the nerve pain characterized by burning, tingling, and numbness, particularly in the feet and calves. The discomfort is described as bloating all over, with painful lumps in the muscles. Additionally, the patient is experiencing nausea and diarrhea. The patient's medical history includes a diagnosis of central sensitization syndrome 2 years ago. The patient's mother has type one diabetes, osteoarthritis, and osteoporosis. The patient is currently taking low dose naltrexone (4.5mg once daily), magnesium glycinate, vitamin D, and occasional ibuprofen (600mg once or twice every couple of days). No known allergies or adverse reactions to medications have been reported.

Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

Post-Surgical Complications: After any surgery, including a hysterectomy, it's common to experience some discomfort, swelling, and pain. However, the onset of these symptoms several weeks after surgery is unusual and may suggest complications such as infection or blood clots.
- Treatment typically involves addressing the underlying cause. For instance, antibiotics may be prescribed for an infection, while blood thinners may be used for blood clots.
Central Sensitization Syndrome: This is a condition where the central nervous system amplifies sensory input across many organ systems, leading to increased sensitivity to pain. It could explain your full body pain, nerve pain, and possibly the stiffness.
- Treatment typically involves a multidisciplinary approach, including physical therapy, cognitive behavioral therapy, and medications to manage the pain.
Fibromyalgia: This is a chronic condition characterized by widespread pain, fatigue, and tenderness in localized areas. It's often associated with Central Sensitization Syndrome.
- Treatment typically involves a combination of medication, exercise, stress management, and healthy lifestyle habits.

Please note that these are possibilities based on the information you've provided, and not a definitive diagnosis. It's important to consult with a healthcare provider for a proper evaluation.

What you can do

Seek immediate medical attention: Given the recent surgery and the sudden onset of swelling, it's important to rule out serious complications such as blood clots.
Continue with your current medications: Unless advised otherwise by a healthcare provider, continue taking your prescribed medications and supplements.
Apply heat: You mentioned that heat helps with the stiffness. Warm baths or a heating pad may provide some relief.
Stay hydrated and eat a balanced diet: This can help manage the diarrhea and nausea.
Gentle exercise: If possible, try to move around a bit to help with circulation and stiffness. However, avoid straining yourself and rest when needed.