Sensation After Surgery

Dear Rosies,

When a surgeon makes an incision, tissue is cut. Small sensory nerves can be cut, stretched, compressed, or caught in the healing process. As those nerves recover, people may experience numbness, tingling, itching, burning, hypersensitivity, or strange electrical sensations. Sometimes sensation returns gradually and often differently.

I wrote about this in my upcoming book, Wake Down: Bringing Light All the Way Into the Body:

“After a cut, it often takes a long while for nerve endings to repair and to come back online, they itch and tingle and then reroute around the scar. Sensation and communication come back, but differently. After surgery, some women describe losing contact with the pelvic floor altogether — the proprioceptive anchors gone, nerves disrupted, fascia restricted, the floor unable to find itself. Cesareans, episiotomies, abdominal surgeries — on the physical map, scars bind fascia and can sever nerves; on the subtle map, what cuts the tissue cuts the current. Both maps call for reweaving: the slow, deliberate remapping through breath, imagery, touch, and downtraining that the practices provide. The map can be redrawn.”

There is good physiology underneath this.

Our sense of our bodies comes from a continual stream of information from skin, muscles, joints, fascia and nerves. When surgery changes tissue and interrupts some of that signaling, the nervous system has to work with different information. Proprioception can change. Sensation can become muted in one area and amplified in another. Pain can persist even after the original tissue injury has healed, involving changes in both peripheral and central nervous-system processing.

We can deliberately bring sensation back to an area through physical stimulation. Even simply placing mental attention on an area changes the conversation we are having with our bodies.

This is where massage and scar care become interesting to me. Research on postoperative scar massage suggests potential benefits for pain, movement and scar characteristics, although the evidence is still developing. There is also research showing benefits from scar massage for symptoms such as pain and itching in hypertrophic scars.^[1]

After a scar has fully healed and you have been cleared for massage, you can slowly explore the area around the scar.

There is something surprisingly profound about this. You are touching the place where the body was changed. You are giving it information. You are allowing sensation to become familiar again. You are asking the nervous system, gently, to pay attention.

A scar can become part of the body's map. So can numbness or pain. And, with time and appropriate rehabilitation, so can new sensation.

And this doesn't have to happen through massage alone. Movement and exercise provide enormous amounts of sensory information. Physical therapy uses graded movement, loading, pressure, balance and repetition precisely because the nervous system is capable of adapting to new information.

Electrical stimulation can provide another kind of input. TENS, or transcutaneous electrical nerve stimulation, stimulates sensory nerves through electrodes placed on the skin. A 2024 systematic review and meta-analysis of 40 studies found that TENS can reduce acute postoperative pain and opioid requirements.^[2] It's another example of the nervous system responding to patterned sensory input.

The body is continually learning from what we tell it, too.  Surgery can leave us with a complicated relationship to a part of ourselves. Ideally we celebrate that scar, that we are repaired, that we survived, that it is evidence of life, but it's not always that way, and sometimes we push it away.  There are ways of talking to the body, including all that its been through and deliberately, offering it love: I am willing to include you. I am willing to feel you. I am willing to let you belong to me.

Sometimes the first thing you notice is almost nothing. Then a tingle. A temperature change. A subtle pull. A place that feels strangely distant. A place that suddenly feels like yours again.

The map can be redrawn. 

To your joyful embodiment,

Christine and the Team at Rosebud Woman

References

[1] Scott HC, Stockdale C, Robinson A, et al. “Is massage an effective intervention in the management of post-operative scarring? A scoping review.” Journal of Hand Therapy, 2022. PubMed PMID: 35227556.

[2] Viderman D, Nabidollayeva F, Aubakirova M, et al. “The Impact of Transcutaneous Electrical Nerve Stimulation (TENS) on Acute Pain and Other Postoperative Outcomes: A Systematic Review with Meta-Analysis.” Journal of Clinical Medicine, 2024. PubMed PMID: 38256561.