Cold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes?
BMJ case reports
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Mole, T., & Mackeith, P. (2018). Cold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes?. BMJ case reports, 2018 https://doi.org/10.1136/bcr-2017-222236
Postoperative neuropathic pain exacerbated by movement is poorly understood and difficult to treat but a relatively common complication of surgical procedures such as endoscopic thoracic sympathectomy. Here, we describe a case of unexpected, immediate, complete and sustained remission of postoperative intercostal neuralgia after the patient engaged in an open-water swim in markedly cold conditions. Though an incidental chance association is possible, the clear temporal proximity linking the swim with pain remission make a causal relationship possible. We discuss plausible mechanisms that may underlie the relationship and discuss the potential implications for postoperative pain management and patient-centred mobilisation. We recommend further evaluation of cold forced open-water swimming as a mobility-pain provocation challenge to see if the observed unexpectedly positive outcome, can be replicated. With the poor response to traditional management, there is a need for novel, curative interventions for postoperative neuropathic pain and associated impaired mobility.
Humans, Neuralgia, Pain, Postoperative, Treatment Outcome, Sympathectomy, Thoracic Surgical Procedures, Swimming, Adult, Male, Cold Temperature
External DOI: https://doi.org/10.1136/bcr-2017-222236
This record's URL: https://www.repository.cam.ac.uk/handle/1810/278421