Post-Thoracotomy Pain Syndrome

Did you have a portion of your lung removed through traditional surgery?  After your incision healed, do you experience pain near and around your incision but it feels like "it's coming from inside."  Well, you are not imagining things and it is possibly post-thoracotomy pain syndrome (PTPS).

What is PTPS?

PTPS is symptoms of pain occurring within the area of the thoracotomy incision and persisting for at least two months or more following the surgical procedure.¹ Keep in mind, when your surgery was performed, your ribs were spread. You may have actually had a rib removed (as I did) to enable your surgeon to get a better angle during surgery.

Symptoms of PTPS

Some of the most common symptoms that people experience are: pain including sharp, stabbing pain along the area of the incision scar, constant shooting pain, pinching sensations, constant dull, achy, and even vague feelings of pain and discomfort, cramping, and localized tenderness.² In my case, my incision comes from under my arm and up my back (near my shoulder blade) so it looks like a "J"  The pain that I feel is from my incision all the way up to my shoulder.  The pain occurs from compression and sensitivity to the nerves where your surgical incision is.  The pain may also be felt in your chest.

Actually, the first day that I realized this was not normal healing pain, was when my shoulder hurt so badly that I couldn't raise up my arm without feeling the pain from my shoulder to the incision.  I mentioned it to my primary care physician, my oncologist, my pulmonologist and, finally, my nurse.  It wasn't until I mentioned it to my nurse that she went and spoke to my medical team and they agreed it was PTPS.

Talk to your care team

Typically, your medical team will try the most conservative approach which would be pain relievers, like NSAIDS. This may provide the relief you need depending on the intensity of the pain; however, many people go on opioids for relief which can cause a whole array of other issues.

Don't be afraid to speak to your medical team if you have pain that hasn't gone away after your surgery.  Your recovery will be slow and steady but over time your pain should disappear.  If it doesn't, begin keeping a log for a few weeks to see if different types of activities cause it, or, do you just wake up with it?

Editor’s Note: We are extremely saddened to say that on January 28, 2020, Jennifer Toth passed away. Jennifer was a passionate advocate for the Lung Cancer community. She will be deeply missed.