Pain of Limb Lengthening Surgery

When it comes to the pain of leg lengthening surgery to get taller or to fix a height length discrepancy there are a group of questions I tend to get asked over and over such as…

• How bad is the pain from the surgery right after and weeks after?
• What can it be compared to?
• Is the pain local in the area of the break or does it radiate?
• Does it get worse when you distract, move around or do physical therapy?
• And finally, what can you do to make the pain more tolerable? 

Alright, so…

How bad is the pain

Well there’s 2 major points you gotta know before we start and that is that the pain is very individual and will vary from person to person and the other thing is that it kinda has different phases, that will go from really painful to barely remembering you had the surgery.

Almost everyone who has had LLS done will agree that the pain is most severe right after you first get done with surgery. I think it’s mainly due to the extreme contrast of feeling fine with no pain before surgery but after you wake up you literally have your legs broken! I mean just let that sink in for a second. Pain from a broken bone due to an accident is bad but in my opinion LLS is even worse because when you have an accident at least your body recognizes what happened and can adapt and release endorphins to help block the pain for a short time. Versus waking up after being under anesthesia where you completely have a lack of sensation and have no clue what’s going on, only to wake up to a pair of broken legs lol. See what I’m saying. That contrast of pain can be pretty shocking to a lot of people. I guess you could compare it to knowing you’re about to jump in a cold pool of water vs getting a cold water bucket thrown on you times 1000 because of that contrast and because you’re getting both legs broken at the same time so that should be expected.

This pain is still harsh for the first few days even with some sort of epidural anesthetic. But you’ll eventually adapt to the pain within the 3 days you’re in the hospital, which is the typical timeframe they keep you there. Before discharging you they’ll slowly wean you off the PCA (patient controlled analgesia the thing where you press the button and you get a nice dose of whatever cloud 9 pain meds they got in there lol). This is replaced by oral pain meds like Percocet or something along with a muscle relaxer before you go home on day 3.

After you’re back home, even though lengthening doesn’t start until about a week after surgery, you still gonna feel a lot of pain. Not only are your legs broken but you now have a gap in your bones with the metallic hardware. Basically, you’re a Cyborg now hence the name! The majority of the pain does in fact come from the local osteotomy site but we humans have nerves too, which can allow the pain to radiate a bit also. I remember having some throbbing down my tibia bone especially in week one. But during week 1: The pain isn’t as bad as the first 3 days but it still hurts. Leading into week 2: you’ll notice that there is a BIG drop-off in pain and this is actually where I stopped taking all pain meds even though you don’t have to. So if you can get to week 2 or 3 the only real pain, or should I say “discomfort”, you might feel is when you do physical therapy or during sleep and each week the pain is much less 

How about during distraction, Physical Therapy or moving around from place to place. Personally, I never noticed actual pain from distraction right after I did it more so later in the day or at night when the muscles and other soft tissues responded to the “stretch” especially when you gain about 70% of your height goal, but again that will vary from person to person. PT- yeah, but it’s actually the ROM exercises they have you do that hurts more than the bone itself because stiff muscles and joints are incredibly painful so you need to stay on top of it and just be tough. Moving around isn’t too bad, just take your normal movement speed and reduce it by half or more to avoid jarring or jerking movements that could cause pain and you’ll be good. 

How to manage the pain: you can always use your pain meds as needed especially if you had a hard PT session deep into your distraction phase. But a special secret that I found helped me big time after the first 2 weeks, that will only work for the internal nail methods, is to use a molded cast they made me to prevent me from rolling around during sleep, I would put it on during the day when I was chilling-out which helped further reduce the swelling thus reducing the pain big time! This was a game-changer for me and it was then that I turned this “painful surgery” into a “waiting game” till I got my height and healed the bone. Of course good nutrition and stretching via PT was big too. 

I do want to stress one last thing is that if you get too much height or more than you should for your current flexibility, then you could complicate your results with chronic pain so definitely discuss with an experienced surgeon how much length you can safely get because that’s really important. And it’s a well known fact that the internal nail LL methods will be less painful than the external fixators but hey I’ve gone through both. Had a PRECICE nail done on my left tibia and monolateral fixator on my right femur so if I can handle it you guys can too.