According to a recently issued prospective comparative study in the Foot & Ankle International Journal, individuals with more severe preoperative pain and psychological distress show a higher risk of being suffered from acute and chronic pain following ankle surgery despite the surgery performed. The analysis involved a total of 49 participants who were assessed for severity, duration, psychological distress, type of preoperative pain, type of surgery and opioid consumption and followed for 18 months. A pain trajectory was used to represent the acute postoperative pain in the first ten days following the operation. Identification of predictors of acute pain trajectory and chronic pain was made by conducting the univariate analysis.

 A total of 87 participants showed preoperative chronic pain, 34% found to have high postoperative pain trajectory, 44% of whom described chronic pain at 18 months. Higher incidence of preoperative neuropathic pain, preoperative opioid consumption, psychological distress score, and brief pain inventory score was seen among patients who exhibited a high acute pain trajectory. The patients suffering from chronic pain showed higher psychological distress score, preoperative pain intensity, and brief pain inventory score. No relationship was observed between pain and type of ankle surgery. These outcomes explain the significant role of psychological distress and severe preoperative pain on postoperative pain after ankle surgery.