Post-Thoracoscopic Surgery Pain: Is It Normal?

What are the side effects after mucosal resection during thoracic surgery?

Hello, Doctor.
I have a question.
In March of this year, I experienced a spontaneous pneumothorax and underwent thoracoscopic surgery, where some tissue was removed.
I was hospitalized for four days and then discharged.
However, after the wound healed, I still experience some minor pain in my chest, and sometimes deep breaths cause sharp pain.
I returned to see the surgeon who performed the operation, and after an X-ray examination, the doctor said everything looked normal and advised me not to worry, assuring me that it would improve over time.
However, two months later, there has been no improvement, and the pain continues intermittently.
I went for another X-ray, and the results were the same as before.
I would like to ask if this pain is considered normal? I once visited another large hospital and consulted a thoracic surgeon, who mentioned that this symptom could cause pain for a lifetime.
Hearing this made me feel quite faint.
The doctor suggested that the pain might be due to nerve damage during the surgery.
Is it true that the pain could last a lifetime?

A Jun, 30~39 year old female. Ask Date: 2015/11/25

Dr. Zhou Ziguang reply Pulmonology

Hello, after chest surgery, there may sometimes be a condition similar to neuropathic pain near the incision site.
If follow-up X-rays show no significant pneumothorax, you may consult a neurologist to discuss this issue.

Reply Date: 2015/11/25

More Info

Post-thoracoscopic surgery pain is a common concern among patients who have undergone procedures such as video-assisted thoracoscopic surgery (VATS) for conditions like spontaneous pneumothorax. It is important to understand that experiencing pain after such surgeries can be a normal part of the healing process, but the nature and duration of this pain can vary significantly from person to person.

After thoracoscopic surgery, patients may experience a variety of symptoms, including localized pain at the incision site, discomfort during deep breathing, and even referred pain in the back or shoulder areas. These symptoms can be attributed to several factors, including the surgical trauma to the tissues, inflammation, and the healing process itself. The chest wall is a complex area with muscles, nerves, and connective tissues, and any surgical intervention can lead to irritation or damage to these structures, resulting in pain.

In your case, the persistent pain you are experiencing, especially during deep breaths, is not uncommon. It is essential to note that while some discomfort is expected in the weeks following surgery, if the pain continues for an extended period, it may warrant further investigation. The fact that your X-rays have returned normal is reassuring, but it does not entirely rule out other potential causes of your pain, such as nerve irritation or musculoskeletal issues.

The mention of "nerve damage" by another physician raises an important point. Surgical procedures can sometimes inadvertently affect the surrounding nerves, leading to conditions such as post-surgical neuropathic pain. This type of pain can be chronic and may require specific treatments, including medications like gabapentin or physical therapy aimed at nerve healing and pain management.

Regarding the concern that this pain may last a lifetime, it is crucial to approach this with a balanced perspective. While some patients do experience chronic pain following thoracoscopic surgery, many others find that their symptoms gradually improve over time. Factors such as individual pain tolerance, the extent of the surgery, and adherence to post-operative care and rehabilitation can all influence recovery outcomes.

If your pain persists or worsens, it would be advisable to consult with a pain specialist or a neurologist who can provide a more comprehensive evaluation. They may recommend additional imaging studies, nerve conduction studies, or other diagnostic tests to better understand the underlying cause of your pain. Additionally, exploring options like physical therapy, acupuncture, or pain management clinics may offer relief.

In summary, while some degree of pain after thoracoscopic surgery is normal, persistent or worsening pain should be evaluated further. It is essential to maintain open communication with your healthcare providers, express your concerns, and seek additional opinions if necessary. With appropriate management and support, many patients can achieve significant improvements in their symptoms and quality of life post-surgery.

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