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BMJ Case Rep. 2018 Feb 12;2018. pii: bcr-2017-222236. doi: 10.1136/bcr-2017-222236.

Cold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes?

Author information

1
Department of Psychiatry, University of Cambridge, Cambridge, UK.
2
School of Health Sciences, University of East Anglia, Norwich, UK.

Abstract

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 makes 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.

KEYWORDS:

cardiothoracic surgery; complementary medicine; pain (neurology); peripheral nerve disease; sports and exercise medicine

PMID:
29440051
DOI:
10.1136/bcr-2017-222236
[Indexed for MEDLINE]

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