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Challenging current approaches to acute pain management after surgery. Chronic postsurgical pain (CPSP) is a complex, multifactorial complication of surgery with significant implications on quality of life, healthy ageing, and healthcare costs. Translational work now provides compelling mechanistic insight into how perioperative modulation of inflammation can shape postoperative pain trajectories. These findings challenge entrenched assumptions underlying multimodal approaches to analgesia and highlight the critical importance of timing, context, and individual biology. Integrating robust translational models with high-quality longitudinal clinical data is essential in guiding strategies to prevent CPSP.