Originally published by our sister publication Pain Medicine News
Chronic postsurgical pain (CPSP) has long been a challenging condition to define, and even more difficult to accurately report its prevalence.
However, with the latest revision of the WHO’s International Classification of Diseases, 11th Revision (ICD-11), a new definition of CPSP has been introduced. This revision should help researchers more reliably report the condition’s prevalence and may influence prescribing practices, particularly by reducing the long-term use of opioids after surgery.
CPSP is often associated with a reduced quality of life and disability, and it can lead to prolonged opioid use, even after minor surgeries.
In the past, epidemiological studies revealed varying rates of the disease due to different definitions with self-defined cutoffs for pain scores.
Historically, epidemiological studies have shown varying rates of CPSP prevalence due to inconsistent definitions and self-defined pain score cutoffs.
In the ICD-11, chronic pain is now recognized as a distinct entity, with an emphasis on its biopsychosocial nature. The updated definition standardizes the criteria for chronic pain, including CPSP, making it easier for healthcare providers to diagnose and treat.
However, this new definition also may suggest that the prevalence of CPSP has been overstated in previous studies. CPSP has been understudied, with prevalence rates ranging from 5% to 85% after high-risk surgeries such as post-mastectomy syndrome, post-thoracotomy syndrome, post-herniotomy syndrome, post-sternotomy syndrome, failed back surgery syndrome, and chronic stump or phantom pain after limb amputation.
“The launch of the 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11) by the World Health Organization (WHO) is a turning point for the diagnosis, classification, and treatment of chronic pain. For the first time, all pain diagnoses are based on a multifactorial and biopsychosocial definition of chronic pain, and hitherto missing diagnoses have been added to the ICD-11, including a precise definition of CPSP,” the authors wrote.
“For clinical practice and research, the evidence-based ICD-11 definition, which provides clear-cut diagnostic criteria, should generally be used instead of pain scores alone,” the investigators wrote. “This will improve the comparability of data, form the basis for future diagnostic and therapeutic approaches, and facilitate communication.”
The study, “Definition of Chronic Postsurgical Pain in the ICD-11: Implications for Anaesthesiology and Pain Medicine,” was published online in the British Journal of Anaesthesia. (2025 Mar 14:S0007-0912(25)00094-7. Online ahead of print).
—Kenny Walter