Undergoing breast surgery, whether for cosmetic purposes or for breast cancer treatment, can be a significant physical and emotional experience. One of the common challenges patients face is dealing with post-operative pain and discomfort. 

Read on to learn more about pain after breast surgery and Post-Mastectomy Pain Syndrome.

How long will I be in pain for after breast surgery?

It is important to understand that some degree of pain or discomfort is normal after any type of breast surgery, including a breast augmentation or reduction, mastectomy, or lumpectomy. Typically, general post-operative pain lasts anywhere between 4-8 weeks.

It is important to keep in mind that everyone is unique. So, even though two people may have the same procedure, they may react differently and experience varying degrees of post-operative pain. One may experience mild discomfort and have only limited difficulty with their daily tasks. While the other, may experience more severe pain that is significantly affecting their daily function and quality of life.

What causes pain after breast surgery?

The most common causes of pain after breast surgery include:

1. Surgical Incisions: The surgical procedures themselves, such as a mastectomy, lumpectomy, or breast reconstruction, can cause general post-operative pain due to the incisions and subsequent scar tissue.

2. Swelling and Seromas: Any acute swelling or localized seromas can also contribute to pain after surgery.

3. Tissue Stretching: Stretching of your skin and the underlying tissues can also cause local pain, due to the placement of breast expanders or breast implants.

4. Shoulder Injury: Some patients may experience pain due to a shoulder dysfunction as a consequence of surgery.

5. Axillary Web Syndrome: Axillary Web Syndrome, also known as cording, is a common cause of pain after breast cancer surgery and lymph node removal.

6. Chest Tightness: The removal of breast tissue, lymph nodes, and changes in the chest wall’s structure can cause chest tightness and subsequent pain.

7. Postural Dysfunction: After any type of breast surgery, it is common to adopt a forward hunched posture to protect the surgical area. Overtime, this altered posture can lead to pain.

8. Nerve Injury or Damage: Damage to the sensory nerves or larger nerves in the area can contribute to pain and may also lead to a chronic condition known as Post-Mastectomy Pain Syndrome.

9. Psychological factors: Pre-existing conditions like anxiety, mood disorders, and sleep disturbances can also contribute to the development of post-surgical pain. 

What is Post-Mastectomy Pain Syndrome?

It's important to note that while most post-operative pain resolves within a few weeks, some patients may develop chronic pain and discomfort. 

When post-operative pain lasts longer than 3 months AND it is associated with sensory changes such as tingling, burning, shooting, itching, and/or pins and needles, this is known as Post-Mastectomy Pain Syndrome (PMPS). 

PMPS is characterized by persistent pain that is neuropathic in nature - meaning it results from damage to the nerves that exchange information between your skin and muscles and your brain and spinal cord. This type of chronic pain can greatly affect your quality of life and recovery following breast surgery. 

The exact causes of PMPS are not fully understood, but it is believed to be related to nerve damage, surgical trauma, and psychological factors. Risk factors seem to include pre-existing pain conditions, anxiety, and genetic predisposition.

Treatment of Pain After Breast Surgery:

While pain after breast surgery is common, it is not something that you need to learn to live with. If you are experiencing pain, please don't hesitate to voice your concerns to your medical team and reach out to a physical or occupational therapist specially trained in Breast Cancer Rehabilitation.

These specialized physical and occupational therapists play a crucial role in the recovery process after breast surgery. In fact, research has shown that early intervention with such a specialized therapist can significantly improve your pain and your overall recovery.

After breast surgery, the goal of occupational or physical therapy is to improve your arm movement, restore your function, and prevent further injury while reducing your pain. They do this by performing a variety of pain-relieving techniques, including:

• Myofascial release

• Soft tissue mobilization

• Manual therapy

• Scar massage

• Targeted exercises

• Breathing techniques

• Relaxation techniques

• Education on posture, positioning, and performing daily tasks

How do you treat Post-Mastectomy Pain Syndrome?

Effective management of PMPS requires a multidisciplinary team of healthcare professionals in order to ensure that both the physical and biopsychosocial aspects of your pain are being addressed. 

A physical or occupational therapist specialized in Breast Cancer Rehabilitation plays an important role in this multidisciplinary team. The specialized therapist with use a variety of interventions such as desensitization techniques, myofascial release, soft tissue mobilization, and exercises to help reduce your pain and normalize your sensation. 

Mindfulness-based cognitive therapy and medications prescribed by your healthcare team are also often used in the management of PMPS.