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Pain after chest wall surgery, and how it is controlled | CION Cancer Clinics
Pain after chest wall resection is expected, because the ribs move with every breath. It is controlled in stages, usually starting with a nerve block or epidural, then a pain pump, then tablets. Most people can breathe deeply, cough and walk from the first days, and the pain eases over the following weeks. This page explains where the pain comes from, how it is treated and when to call. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- How much pain is normal after chest wall surgery?
- Why does the chest hurt in so many places?
- How does the pain change from the theatre to home?
- Which medicines are used for pain after this operation?
- What do families believe about pain that is not true?
- What if the pain does not go away?
- Common questions about pain after chest wall surgery
The short answer
How much pain is normal after chest wall surgery?
Chest wall surgery is one of the more painful operations, because the ribs move with every breath. With the right pain control, most people can breathe deeply, cough and walk from the first days, and the pain eases steadily over the following weeks.
Why pain control matters so much here
Pain in the chest makes you breathe shallowly and avoid coughing. That lets mucus sit in the lungs, and the base of the lung can close down. Chest infection is one of the main problems after this operation, so good pain relief is part of the treatment, not a comfort extra.
What the page cannot tell you
How much pain you have depends on how many ribs were removed, whether the breastbone was involved, the type of repair and your own body. This page explains the usual pattern. Your anaesthetist and surgeon will plan the pain relief for your own operation.
Where it comes from
Why does the chest hurt in so many places?
Pain after this operation has more than one source. Telling the team what the pain feels like helps them choose the right medicine.
The cut bone and repair
Where ribs or breastbone were cut, the ends are sore and ache when you move. A mesh or plate can feel tight or stiff while the tissue settles around it.
The nerves under the ribs
A nerve runs under each rib. When ribs are removed or stretched, these nerves can be bruised or cut.
It often feels like
- Burning or shooting pain
- Numbness around the scar
- Skin that hurts to touch
The chest drain
The tube between the ribs is often the most uncomfortable part of the first days. The pain usually settles soon after it comes out.
Muscles and shoulder
Muscles cut or moved during the repair ache as they heal. Pain in the shoulder on the same side is also common, and it is often from how you lay on the table.
Not sure whether this applies to you?
Ask an oncologistOver time
How does the pain change from the theatre to home?
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During the operation
Pain relief starts before you wake. The anaesthetist may place a thin tube near the spine, such as an epidural or a nerve block, which numbs the chest wall for the first days.
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The first days on the ward
You may have a pump with a button that gives you a small dose of pain medicine when you press it. Nurses will ask you to score your pain often. Tell them honestly.
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Moving to tablets
Once the tube and drain are out, pain relief moves to tablets. The aim is that you can breathe deeply and walk the corridor, not that you feel nothing at all.
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Going home
You leave with a written list of tablets and when to take them. Pain is usually worse in the evening and when you have done more than usual.
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The weeks after
The ache fades gradually. Some people are left with numbness or tingling around the scar that lasts longer, and a few develop lasting nerve pain that needs its own treatment.
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Pain that cannot wait until your next review
Call your surgical team the same day, or go to the nearest emergency department, if pain suddenly gets much worse, or comes with fever, breathlessness, a wound that is red, hot or leaking, or a patch of chest that moves inwards when you breathe in. Do not simply take extra tablets and wait for it to pass.
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Pain relief
Which medicines are used for pain after this operation?
Most people take a combination of medicines, because each one works on a different kind of pain. Using several together often means lower amounts of the strongest ones.
The everyday base
Paracetamol is usually given regularly, not only when the pain is bad. Anti-inflammatory tablets such as diclofenac or ibuprofen may be added, though they do not suit people with kidney problems, stomach ulcers or some heart conditions.
Stronger medicines
Tramadol, morphine or similar medicines may be prescribed for the first period. They cause constipation and drowsiness, so a laxative is often given alongside. Taken as prescribed for surgical pain, they are reduced as the pain eases.
Medicines for nerve pain
Burning or shooting pain does not always respond to ordinary painkillers. Pregabalin or gabapentin may be used for this.
Never stop, start or change any of these on your own. The dose and when to reduce it are set by your doctors.Commonly believed
What do families believe about pain that is not true?
"A strong person should bear the pain quietly."
Pain that is not treated stops you breathing deeply and coughing, and that raises the chance of a chest infection. Asking for pain relief is part of recovering well, not a sign of weakness.
"Strong painkillers will make him addicted."
Used for a short period after surgery and reduced under a doctor's guidance, this is rare. The team plans how the stronger medicines are stepped down as the pain settles.
"Coughing will break the repair."
The repair is built to take coughing. Holding a folded towel or pillow firmly against the chest while you cough makes it more comfortable. Not coughing is the bigger risk.
"If it still hurts, the surgery has gone wrong."
Aching for weeks is expected after ribs are removed. What matters is the pattern: pain that slowly improves is normal. Pain that suddenly worsens needs a call to the team.
Longer term
What if the pain does not go away?
A small group of people have pain around the scar that continues long after the wound has healed. It usually comes from the nerves under the ribs, and it is real, not imagined.
What can help
Your surgeon may refer you to a pain specialist. Options include nerve pain medicines, injections that numb the nerve, and physiotherapy to loosen the shoulder and chest. Pain teams can often reduce it a good deal, even when it cannot be removed completely.
Questions to ask before surgery
Ask what pain relief is planned for the first days, and whether an epidural or nerve block will be used. Ask who to call about pain after you go home, and whether a pain team is available.
Questions we are asked
Common questions about pain after chest wall surgery
Is chest wall surgery more painful than other operations?
It is often more painful than an operation on the belly, because the chest moves with every breath and the nerves under the ribs are close to the surgery. That is why the anaesthetist plans pain relief carefully, often with a nerve block or epidural, before you wake up.
How do I sleep with pain in my chest?
Many people find sleeping propped up on pillows easier than lying flat. Lying on the side that was not operated on can also help. Take your evening pain tablets as prescribed, and tell the team if pain keeps waking you, because the timing of the medicines can often be adjusted.
Why is my skin numb around the scar?
Small skin nerves are cut during the operation, so a patch of skin around or below the scar often feels numb or odd. It commonly improves over months, though some numbness can stay. It is not a sign of a problem unless it comes with redness, swelling or leaking.
My mother will not say she is in pain. What should I do?
This is very common, especially in older people. Watch for shallow breathing, avoiding coughing, not wanting to move, or grimacing when she shifts in bed. Tell the nurse what you notice. The team would much rather adjust her medicines than have her breathe poorly.
Can I take my usual painkiller from home instead?
Only if your team agrees. Some pain medicines react with others, or do not suit your kidneys or stomach after surgery. Show the ward doctor every medicine you normally take, including ayurvedic and over-the-counter ones, and follow the written list you are given when you leave.
Does a hot water bag help chest wall pain?
Gentle warmth on a sore shoulder or back muscle can feel soothing. Do not put heat on or near the wound, and be careful over numb skin, because you may not feel a burn happening. Ask the team or physiotherapist before using heat in the first weeks.
Is shoulder pain normal after chest surgery?
Yes, it is common. It can come from how you were positioned on the table, from muscles moved during the repair, or from the drain. Gentle arm and shoulder exercises from the physiotherapist help. New shoulder pain with breathlessness or fever needs a call to the team.
Will the pain come back if the cancer comes back?
Most pain after this operation is from healing, not from cancer. Pain that appears in a new place, keeps getting worse instead of better, or wakes you every night should be reported at your follow-up. Your team may arrange a scan to check, rather than guessing.
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Sources
- NHS — Epidural anaesthesia
- Cancer Research UK — Surgery for cancer
- Macmillan Cancer Support — Surgery
- American Cancer Society — Cancer pain
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.
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