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Pain after thoracic surgery, and how it is kept under control | CION Cancer Clinics
Pain after lung surgery is expected, and it can usually be kept under control. It comes mostly from the nerves under the ribs and from the chest drain. Open surgery tends to hurt more than keyhole surgery. Good pain relief matters because it lets you breathe deeply, cough and walk, which protects your lungs. This page explains the options, how pain changes and when to get it checked. 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 does it hurt after lung surgery, and why?
- What pain relief might you be offered?
- How does the pain usually change after the operation?
- What do the words the pain team uses mean?
- What do families believe about pain after chest surgery?
- What helps with pain once you are home?
- When should pain be checked, and what can this page not tell you?
- Common questions about pain after lung surgery
The short answer
How much does it hurt after lung surgery, and why?
Pain after lung surgery is real, and it is expected. With good pain relief, most people can breathe deeply, cough and walk from the first day or two, which is the whole aim of controlling it.
Why the chest hurts more than many operations
Your chest moves with every breath, thousands of times a day, so the wound is never fully at rest. To reach the lung, the surgeon works between two ribs. Along the lower edge of each rib runs a nerve. Those nerves get pressed and stretched during the operation, and that is where much of the pain comes from. The chest drain adds its own soreness where it enters the skin.
Open surgery and keyhole surgery feel different
A thoracotomy is open surgery through a longer cut, with the ribs gently spread apart. Keyhole surgery, called VATS, uses a few small cuts and a camera. Pain after keyhole surgery is usually less and settles faster, but it is not absent. Some people are surprised by how sore a small cut can be, especially where the drain sat.
Why controlling it matters for your lungs
If breathing in hurts, you take shallow breaths and avoid coughing. Phlegm then collects in the lung, and that raises the chance of a chest infection. Asking for pain relief is not weakness. It is part of your recovery.
In hospital
What pain relief might you be offered?
Most people receive a combination. The anaesthetist chooses with you, based on the operation and your health.
An epidural
A thin tube placed in the back delivers numbing medicine near the spinal nerves. It can control chest pain very well for the first few days.
It may not suit people on blood thinners or with some spine problems.A nerve block beside the spine
Called a paravertebral or erector spinae block. Numbing medicine is given close to the nerves on the side of the operation only, sometimes through a small tube left in place.
A button you press yourself
Called PCA. A pump connected to your drip gives a small, safe amount of strong painkiller when you press the button. The pump has a lock, so you cannot give yourself too much.
Tablets and drips
Given on a regular schedule rather than only when pain is bad.
Commonly used
- Paracetamol
- Anti-inflammatory medicines, if your kidneys and stomach allow
- Tramadol or morphine-type medicines for stronger pain
Not sure whether this applies to you?
Ask an oncologistOver time
How does the pain usually change after the operation?
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Waking up
The block or epidural is usually already working. You will be asked to score your pain. Say honestly if it is high, even if you do not want to trouble anyone.
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The first few days
Pain is often worst when you cough, move or sit up. The physiotherapist will time exercises for when pain relief is working best.
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When the drain comes out
Many people notice a clear improvement once the chest drain is removed. The drain site can stay sore for a while.
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Going home
The epidural or pump is switched to tablets before you leave. You should go home with a written plan saying what to take and when.
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The weeks at home
Pain should ease steadily. Aching, tightness and odd numb patches around the wound are common while the nerves recover.
On the ward
What do the words the pain team uses mean?
- Pain score
- A number you give from none to the worst pain imaginable. It helps nurses see whether your medicine needs changing.
- Thoracotomy
- Open chest surgery through a cut along the side of the chest, between two ribs.
- VATS
- Keyhole chest surgery using a small camera and a few short cuts.
- Opioid
- A strong painkiller in the same family as morphine. Safe when prescribed and watched, but it can cause constipation and drowsiness.
- Intercostal nerves
- The nerves that run under each rib. Their irritation is the main source of pain after chest surgery.
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Commonly believed
What do families believe about pain after chest surgery?
"He should bear the pain. Painkillers slow healing."
The opposite is closer to the truth. Untreated pain stops deep breathing and coughing, which is how chest infections start. Good pain relief helps the lung recover.
"Morphine means she will get addicted."
Short courses for pain after surgery, prescribed and reduced by your team, rarely lead to addiction. The dose is brought down as the wound heals. Ask the team how and when that will happen.
"Keyhole surgery should not hurt at all."
Keyhole surgery usually hurts less, but the ribs and nerves are still involved and a drain is still placed. Feeling sore is normal and not a sign that something has gone wrong.
"If the pain is still there after a month, the cancer is back."
Nerve healing is slow, and aching or tingling around the scar for weeks is common. Pain that keeps getting worse, or comes with new symptoms, should be checked, but lingering soreness alone is not a sign of cancer.
At home
What helps with pain once you are home?
- Take regular tablets on time, not only when pain is bad
- Hold a pillow firmly against the wound when you cough
- Keep walking a little more each day
- Wear soft, loose clothes over the scar
- Ask about a laxative if you are on strong painkillers
- Sleep propped up on pillows if lying flat hurts
Being straight with you
When should pain be checked, and what can this page not tell you?
Call your surgical team, or go to the nearest emergency department, if chest pain is sudden and sharp, if breathing becomes much harder, or if you have a fever, redness or discharge from the wound. Pain in the calf or a swollen leg also needs checking the same day.
Who the usual plan may not suit
Some pain medicines are not safe for everyone. Anti-inflammatory tablets may not suit people with kidney disease, stomach ulcers or some heart problems. Epidurals may not suit people on blood thinners. If you already take painkillers for another condition, tell the anaesthetist before the operation. Do not stop, start or change any medicine on your own.
What this page cannot tell you
It cannot tell you how much pain you will have, or how long it will last. That depends on the operation, your own nerves and how you heal. If pain is still troubling you months after surgery, ask about longer-lasting nerve pain. It has a name and it can be treated.
Questions we are asked
Common questions about pain after lung surgery
How long does pain last after a thoracotomy?
The sharpest pain usually settles over the first weeks, and most people need fewer painkillers each week. Aching, tightness and numbness around the scar can take several months to fade as the nerves recover. Everyone is different, so use this as a rough guide rather than a deadline.
Why does my shoulder hurt when the operation was on my chest?
Shoulder pain is common after chest surgery. It can come from how you were positioned on the operating table, from the drain irritating nerves, or from stiff muscles. Gentle arm and shoulder exercises from the physiotherapist usually help. Tell the team if it is severe or getting worse.
Is it normal for the skin near the scar to feel numb?
Yes. A patch of numb or tingling skin below and in front of the scar is very common, because the nerve under the rib was disturbed. It often improves slowly over months. Some people keep a small numb area. It is not dangerous, but mention it at follow-up.
Can I take my own painkillers from home?
Tell the ward what you take, including over-the-counter tablets and ayurvedic or herbal products. Some combine badly with the medicines you are given in hospital. Do not take extra tablets of your own without asking, because it is easy to double up on paracetamol without realising.
Will coughing open my stitches?
No. The wound is closed in layers and is strong enough for coughing. Holding a folded towel or pillow firmly over the wound makes coughing far more comfortable. Coughing clears phlegm from the lung, which is exactly what you need to do.
The painkillers make me constipated. What can I do?
Strong painkillers commonly slow the bowel. Drink plenty of water, walk as much as you can, and include fruit and vegetables. Ask your team for a laxative rather than stopping the painkiller, because stopping may bring the pain back and make breathing exercises harder.
When can I sleep on my side?
Many people find sleeping on the side of the operation uncomfortable at first. Propping yourself up on pillows, or lying on the other side, is fine. There is usually no harm in trying your usual position once it feels comfortable. Ask your team if you have a drain or a specific instruction.
Does a longer pain-control stay cost more?
An epidural or nerve block may add to the bill, and extra days on the ward do too. What you pay depends on your package and cover. Aarogyasri, CGHS, ECHS, EHS and cashless insurance may cover much of it. Ask the billing desk before the operation what is included.
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Sources
- Cancer Research UK — Surgery for lung cancer
- Macmillan Cancer Support — Lung cancer
- NHS — Lung cancer: treatment
- American Cancer Society — Surgery for non-small cell lung 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.
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