Medical Oncologist
After your operation
Chronic post-surgical pain months after the operation
Pain continuing months after breast surgery is most likely nerve pain from nerves divided during the operation. It is a recognised condition, it is not the cancer returning, and it is not something to live with quietly. It responds to specific treatments that are quite different from ordinary painkillers.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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The short answer
Why am I still in pain months later?
Most likely nerve pain from nerves divided during the operation. It is a recognised condition after breast surgery, it is not the cancer returning, and it is not something you have to live with quietly. It responds to specific treatments that are different from ordinary painkillers.
What it typically feels like
Burning, shooting, stabbing or electric sensations in the chest wall, the armpit or the inner upper arm. Often worse at night, often unrelated to movement, and frequently in an area that is also numb, which patients find confusing to describe.
Why it is so often missed
Women assume persistent pain is the price of cancer surgery and never raise it. Doctors focused on the cancer may not ask. The result is that a treatable condition goes untreated for years, which is the main reason this page exists.
Who is more likely to have it
Those who had extensive armpit surgery, radiotherapy to the armpit, reconstruction, poorly controlled pain in the first days after surgery, or who are younger at the time of operation. Several of these travel together.
Use the words burning, shooting or electric when you describe it. That is what points to the right treatment.What is done
How persistent pain is treated
Usually several things together rather than one answer.
Medicines for nerve pain
A different group from ordinary painkillers, started at a low dose and built up slowly. They take weeks to show their full effect, which is why people abandon them too early.
Physiotherapy
Particularly where stiffness, cording or a tethered scar is contributing. Desensitisation techniques also help skin that is uncomfortable to touch.
Ask for a referral; it is rarely offered automatically.Topical treatments
Creams and patches applied to the painful area act locally with fewer whole-body effects. Useful where the pain is in one defined patch.
A pain clinic
For pain that has not responded to the usual measures. Referral is a reasonable next step rather than a last resort, and they have options a general clinic does not.
Ask about
- Nerve pain medicines specifically
- Physiotherapy referral
- Pain clinic referral if nothing works
Not sure whether this applies to you?
Ask an oncologistSide by side
Nerve pain, and pain that needs investigating
Typical of nerve pain
Worth investigating separately
Burning, shooting or electric in character
A new lump you can feel
In the chest wall, armpit or inner arm
Bone pain in one spot that wakes you at night
Present since surgery, stable or slowly easing
New pain starting long after recovery
In an area that is also numb
Skin changes, redness or a rash over the area
Worse at night, unrelated to movement
Pain with weight loss or breathlessness
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Words you will hear
The vocabulary, in plain language
- Post-mastectomy pain syndrome
- The usual name for persistent nerve pain after breast surgery. It occurs after lumpectomy too, despite the name.
- Neuropathic pain
- Pain generated by nerves rather than by damaged tissue. It needs different medicines from ordinary painkillers.
- Allodynia
- Pain from something that should not hurt, such as clothing brushing the skin. Common in this condition.
- Intercostobrachial nerve
- The nerve crossing the armpit, often divided during node surgery and frequently the source of this pain.
- Desensitisation
- Gradually stimulating the painful area to retrain the nervous system. Taught by physiotherapists.
- Pain clinic
- A specialist service for pain that has not responded to usual treatment. Referral is appropriate rather than exceptional.
Being straight with you
What treatment can realistically achieve
The realistic goal is usually substantial reduction rather than complete disappearance. Most women get to a point where the pain no longer dominates the day or disturbs sleep. Being told that honestly at the start prevents a lot of disappointment.
The medicines take time
Nerve pain medicines are started low and increased slowly over weeks, and the side effects often arrive before the benefit. People stop after a few days, conclude they do not work, and miss a treatment that would have helped. Ask how long to persist before judging.
Pain and mood feed each other
Persistent pain wears people down, and low mood makes pain harder to tolerate. Addressing both works better than treating either alone. This is not a suggestion that the pain is in your head; it is how chronic pain behaves in everyone.
Keep a short record before the appointment
For a week, note where the pain is, what it feels like in your own words, what score out of ten, and what makes it better or worse. Ten minutes of writing turns a vague complaint into something a doctor can act on, and it usually reveals a pattern you had not noticed.
Ask again if you are dismissed
Some women are told this is simply how it is now. It is a recognised condition with recognised treatments. Ask specifically for nerve pain medicines, for physiotherapy, and for a pain clinic referral if those do not help.
Commonly believed
Why this goes untreated for so long
Pain after cancer surgery is just something to accept.
Persistent nerve pain after breast surgery is a recognised condition with specific treatments. Accepting it usually means going without medicines that would help. Nobody should be enduring this silently years later.
Pain months later means the cancer is back.
Far more often it is nerve pain from the operation. It still deserves assessment, and a new lump, bone pain in one spot that wakes you, or pain with weight loss are different findings that need investigating. Report it, without assuming the worst.
The tablets did nothing after a week, so they failed.
Nerve pain medicines are built up slowly and take weeks to show their full effect, with side effects often arriving first. Stopping early is the commonest reason they appear not to work. Ask how long to persist before judging.
Being offered an antidepressant means they think it is psychological.
Several medicines developed for depression are genuinely effective for nerve pain at different doses, and that is why they are prescribed here. It is not a comment on your mental state. Ask your doctor to explain which effect they are aiming for.
Questions we are asked
Common questions about persistent pain
How common is this?
Common enough that most breast units see it regularly, and far commoner than the number of women who report it. Extensive armpit surgery, radiotherapy and being younger at operation all raise the chance. You are not unusual for having it.
Will it ever go away completely?
For some women it fades over a year or two. For others it persists but becomes much more manageable with treatment. The realistic goal is usually substantial reduction rather than complete resolution, and most people get there.
Which doctor should I raise this with?
Your oncologist, surgeon or breast care nurse can all start the process, and your family doctor can prescribe nerve-pain medicines. Be specific that the pain is burning or electric, because that word choice is what directs the treatment.
Are the medicines addictive?
The main medicines used for nerve pain are not the addictive kind, though some should not be stopped abruptly and are reduced gradually. If you are concerned about a particular tablet, ask directly what it is and how it is stopped.
Can physiotherapy really help pain?
Yes, particularly where stiffness, cording or a tethered scar is contributing, and for skin that is uncomfortable to touch. Desensitisation techniques are genuinely effective. Ask for a referral rather than assuming physiotherapy is only about movement.
Does radiotherapy make it worse?
Radiotherapy to the armpit does raise the chance of persistent nerve pain, and discomfort often increases during and shortly after treatment. It usually eases again over the following months. Tell your team if it does not.
Should I have a scan to rule out recurrence?
Your team will examine you and decide. Scanning everyone with persistent pain finds far more harmless things than useful ones. What prompts imaging is a new lump, a change on examination, or pain with other symptoms.
What if my doctor says nothing can be done?
Ask specifically for nerve-pain medicines, for a physiotherapy referral, and for a pain clinic referral if those do not help. Naming the treatments changes the conversation. A second opinion is reasonable if you are still dismissed.
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Sources
- Cancer Research UK — Cancer and pain control
- National Cancer Institute — Pain control in people with cancer
- Breast Cancer Now — Pain after breast surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.