World's Most Painful Medical Procedures: An Expert's Insight
Medical procedures are essential and life-saving, yet they are often far from painless. Even surgeries performed under general anaesthetic, designed to block pain during the operation, can lead to significant discomfort during recovery. Some procedures, however, stand out as particularly painful, regardless of an individual's pain tolerance. Dr Dean Eggitt, a consultant primary care physician, has ranked the world's most painful surgeries and procedures to help patients understand what to expect and how to make recovery as smooth as possible.
Dr Eggitt notes that major surgery is not always more painful than minor operations, partly due to the pain medication administered. 'Whilst everyone will experience pain differently, there are definitely some procedures that are more painful than others like spinal fusion, open chest surgery and total knee replacement,' he told the Daily Mail. 'All of these procedures disrupt bones and nerves and cannot have total immobilisation afterwards. So whilst the actual surgery might not be too painful, the extensive physiotherapy required for full recovery can be very painful.'
Bone Marrow Biopsy: A Procedure Known for Its Discomfort
A bone marrow biopsy is performed for two main reasons: to collect stem cells for donation or to test for cancer cells. Bone marrow, the spongy tissue found in the centre of some bones, produces red blood cells, white blood cells, and platelets. Stem cell transplants treat conditions like leukaemia, lymphoma, and sickle cell anaemia, where bone marrow is damaged.
Patients undergo local or general anaesthetic before a needle is inserted into the hip bone to extract liquid bone marrow. Those under local anaesthetic may feel a pulling sensation as cells are drawn out. Post-procedure, a puncture wound and bruising are common, with aching in the bone lasting a few days, manageable with mild painkillers. There is also a small risk of infection, which can cause fluid to ooze from the site.
Lumbar Puncture: The Dreaded Spinal Tap
Also known as a spinal tap, this procedure involves inserting a needle into the lower back between the spine bones. It is one of the most feared medical procedures because patients must be awake for it to work. Used to diagnose brain or spine conditions, treat infections or cancers, or administer anaesthetic, the needle insertion often causes pressure, discomfort, and pins and needles.
After a lumbar puncture, headaches, back pain, bleeding, and swelling are common. In rarer cases, it can lead to long-term back pain, infection, nerve damage resulting in loss of feeling in limbs, hearing loss, double vision, and blood clots.
Open-Heart Surgery and Sternotomy: Chest Pain Explained
Open chest surgery involves a large incision in the chest to access the heart and lungs, typically performed under general anaesthesia. After surgery, the sternum is wired together with stainless steel wires, taking about 12 weeks to heal. Muscles and skin are then sewn shut.
Patients experience moderate to severe pain initially, worsened by movement, coughing, and deep breathing. Aches, stiffness, and numbness in the back, neck, shoulders, arms, and chest are normal due to surgery effects on the breastbone and ligaments. The NHS advises taking painkillers regularly to manage discomfort and facilitate movement and recovery.
Total Knee Replacement: A Painful Rehabilitation Process
Knee replacements vary in pain levels, but Dr Eggitt explains that the significant rehabilitation required makes this procedure one of the most painful. Cartilage wear from injury or osteoarthritis causes bones to rub, leading to pain and stiffness. In a total replacement, the thigh and shin bones are replaced with metal and plastic parts, with the knee cap repositioned.
Recovery time depends on age and health, but Dr Eggitt emphasises starting to walk soon after surgery with crutches or a walking frame. 'The longer it takes to get moving, the harder it will be,' he says. The NHS recommends walking for five minutes every hour to prevent blood clots and keeping the leg raised to reduce swelling.
Hysteroscopy: A Procedure with High Pain Reports
A hysteroscopy examines the inside of the womb using a thin telescope passed through the cervix. According to the Royal College of Obstetricians and Gynaecologists, a third of women report pain levels of seven or more out of ten. Patients should be offered local or general anaesthetic, with medical history considered.
While uncomfortable, the test helps diagnose issues like fibroids, repeated miscarriages, and post-menopausal bleeding. To manage pain, the NHS suggests taking ibuprofen or paracetamol before the procedure and requesting anaesthetic or relaxation injections, though not all clinics offer this.
