Medical Oncologist
CION Cancer Clinics
Is liver ablation painful? Anaesthesia, soreness and recovery | CION Cancer Clinics
You should not feel the ablation itself, because it is done under general anaesthesia or deep sedation. Afterwards most people have an ache under the right ribs, sometimes in the shoulder, that eases over a few days. This page explains the anaesthesia, how the pain usually changes, which painkillers suit a damaged liver, and which kind of pain means going to hospital today. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- Will I feel pain during liver ablation?
- What kind of anaesthesia is used for liver ablation?
- How does the pain usually change after ablation?
- Which painkillers are safe with a damaged liver?
- What families often fear about ablation, and what is true
- What this page cannot tell you
- Common questions about pain and liver ablation
The short answer
Will I feel pain during liver ablation?
You should not feel the ablation itself. It is done under general anaesthesia or deep sedation, so you are asleep or very drowsy while the needle heats or freezes the tumour. Most people do have some soreness afterwards, usually for a few days, and it is managed with tablets.
Where the discomfort comes from
Ablation reaches the tumour through a thin needle passed through the skin, guided by ultrasound or CT. There is no long cut. The ache you feel later comes from three places: the small puncture in the skin, the treated area of liver healing, and sometimes the thin lining around the liver, which is sensitive. If the tumour sits close to that lining or to the diaphragm, the soreness tends to be stronger.
Why this matters for the decision
For a small liver cancer, ablation can be curative without open surgery. Fear of pain is one reason some families delay or refuse it. In practice, recovery from ablation is usually much easier than recovery from an operation. Read how liver ablation works if you are still deciding.
This page is about ablation for a tumour in the liver. Pain after TACE is different and has its own page.Keeping you comfortable
What kind of anaesthesia is used for liver ablation?
The choice is made by the anaesthetist and the interventional radiologist together, based on where the tumour sits and how well your liver and heart work.
General anaesthesia
You are fully asleep and a machine helps you breathe. Many teams prefer it because it keeps you completely still, and it lets them pause your breathing for a moment so the needle reaches the target exactly.
Deep sedation
Medicine through a drip makes you very drowsy and comfortable. You breathe on your own. Most people remember little or nothing of the procedure afterwards.
Local anaesthetic at the skin
An injection numbs the spot where the needle goes in. It is used together with sedation or general anaesthesia, not on its own, because heating the liver needs more than a numb skin.
What the anaesthetist checks first
- How well the liver is working, from your blood tests
- Your heart, lungs and any sleep apnoea
- Blood clotting and platelet count
- Every tablet you take, including herbal ones
Not sure whether this applies to you?
Ask an oncologistHour by hour
How does the pain usually change after ablation?
Waking up
You may feel groggy and have a dull ache under the right ribs. The nurses ask you to score your pain and give medicine through the drip if you need it. Tell them early rather than waiting for it to build.
The first night
Many people stay in hospital overnight. The ache is often worst now. Some people feel it in the right shoulder tip, because the nerve from the diaphragm shares a path with the shoulder. This is expected.
The next few days at home
Soreness eases day by day. Some people have a mild fever, tiredness and aches for a few days, called post-ablation syndrome. It is the body clearing the treated tissue.
Back to ordinary life
Most people walk about the same day or the next, and return to light routines soon after. Your team will say when heavier lifting and travel are fine. See recovery after liver ablation.
Pain relief and the liver
Which painkillers are safe with a damaged liver?
- Paracetamol
- Usually the first choice, even with cirrhosis, but within a limit your doctor sets for your liver. Do not add extra from cold and flu sachets, which often contain it too.
- Ibuprofen and similar painkillers
- Usually avoided with cirrhosis. They can harm the kidneys, cause stomach bleeding and make fluid build up in the abdomen.
- Stronger painkillers
- Sometimes needed for a short while. With a weak liver they can cause drowsiness and confusion, so they are given carefully and stopped as soon as possible.
- Herbal pain balms and tonics
- Tell your team about anything you use. Some herbal products can injure a liver that is already scarred.
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Pain that is not normal: go to hospital today
Ordinary soreness gets a little better each day. Go to hospital today if the pain suddenly gets much worse, if your abdomen swells or feels tight, if you feel faint or dizzy, if you shiver with a high fever, if you become breathless, or if your skin or eyes turn yellow. These can be signs of bleeding, infection or a liver problem that needs a doctor quickly. Take your ablation discharge papers with you.
Commonly believed
What families often fear about ablation, and what is true
"Burning the tumour must hurt terribly."
You are asleep or deeply sedated during the heating. What people feel afterwards is usually an ache, closer to a bruise than a burn, and it fades over a few days.
"An elderly parent cannot take anaesthesia."
Age alone does not rule it out. The anaesthetist looks at heart, lungs and liver function. Ablation is often chosen precisely because it is gentler than an operation for an older or frailer person.
"Asking for more pain medicine is weakness."
Pain that is controlled helps you breathe deeply, walk sooner and recover faster. Nurses want to know your score. Telling them is part of the treatment, not a complaint.
"More pain afterwards means the ablation failed."
How sore you feel says little about whether the tumour was fully treated. Only the follow-up scan answers that.
Being straight with you
What this page cannot tell you
It cannot tell you how much pain you will have. That depends on where the tumour sits, how many are treated, the type of ablation and your own liver. The interventional radiologist who plans your procedure can give you a much better idea once they have seen your scan.
Who this does not apply to
This page does not describe open or keyhole liver surgery, TACE, radiation, or ablation of other organs. If your plan is one of those, the pain and recovery are different. It also does not apply to cancer that spread to the liver from the bowel, which is covered on the colon cancer pages.
How CION fits in
CION's tumour board reviews your scans and liver tests and decides whether ablation suits you. The ablation itself is done by interventional radiologists at NABH-accredited partner hospitals, which CION coordinates. Your CION team stays with you for follow-up and the check scans afterwards. Read about the risks and complications of liver ablation before you decide.
If you are worried about pain, say so at the first appointment. A plan made in advance works better than one made in a hurry.Questions we are asked
Common questions about pain and liver ablation
Will I be awake during liver ablation?
Usually not in any way you will remember. Most teams use general anaesthesia, and some use deep sedation where you are very drowsy and comfortable. The choice depends on where the tumour sits and on your health. Ask the anaesthetist which they plan for you and why.
How long does the pain last after ablation?
For most people it is a few days of soreness that eases each day. A tumour close to the surface of the liver or the diaphragm can ache a little longer. If pain is getting worse rather than better after the first couple of days, call your team or go to hospital.
Why does my right shoulder hurt after liver ablation?
The diaphragm sits on top of the liver, and its nerve shares a pathway with the skin of the shoulder. When the area under the diaphragm is irritated, the brain reads it as shoulder pain. It is common and usually settles on its own within a few days.
Is ablation less painful than liver surgery?
In general, yes. There is no large cut, so most people are up and walking much sooner and need strong painkillers for less time. Ablation only suits certain tumours, though. The choice between the two is about the tumour and the liver, not only about pain.
Can I take paracetamol at home after ablation?
Usually yes, but only in the amount your doctor sets for your liver. Cirrhosis changes what is safe. Avoid ibuprofen and similar painkillers unless your doctor says otherwise, and check combination cold remedies, which often contain paracetamol too.
Is fever after ablation a sign of infection?
A mild fever with aches in the first few days is common and is usually the body reacting to the treated tissue. A high fever with shivering, a fever that starts later, or a fever with worsening pain needs a doctor the same day, because an infection in the treated area is possible.
Do I need someone with me after ablation?
Yes. After anaesthesia or sedation you should not travel alone or drive. Families coming from a district usually plan to stay near the hospital for the first night or two. A family member also helps you notice if the pain is getting worse instead of better.
Who decides whether I am suitable for ablation?
A tumour board looks at the size, number and position of the tumours and how well the liver works. At CION that review happens before any procedure is arranged. Call the CION helpline to have your scans and reports looked at, and to ask any questions about anaesthesia and pain.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- American Cancer Society — Liver Cancer Ablation: RFA, MWA, Cryotherapy, PEI, Histotripsy
- Cancer Research UK — Treatment for liver cancer
- RadiologyInfo.org (RSNA/ACR) — Management of liver cancer (ACR Appropriateness Criteria, patient summary)
- NHS — Treatment for liver cancer
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.
Keep reading
Related pages
What happens on the day of ablationThe procedure step by step, from arrival to going homeRecovery after liver ablationWhen you can walk, work and travel againPost-ablation syndromeWhy fever and aches are common in the first daysRisks and complications of liver ablationWhat can go wrong, and how often it is serious
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Worried about pain before an ablation?
Send us your scans and reports and we will explain whether ablation suits you and how pain would be handled. One helpline serves every CION centre.