Postmastectomy pain syndrome is a type of nerve pain that can occur after breast cancer surgery. Treatments, including medications, nerve blocks, and physical therapy, can help manage this condition.

Aside from skin cancer, breast cancer is the most common cancer in people assigned female at birth. The American Cancer Society (ACS) estimates 310,720 new diagnoses of female breast cancer in the United States in 2024.

Most people with breast cancer will have surgery as a part of their treatment plan. This may involve breast-conserving surgery or a mastectomy.

Some people have persistent nerve pain in their chest, armpit, or arm after breast cancer surgery. While the term for this is postmastectomy pain syndrome (PMPS), it can occur after any type of breast cancer surgery.

PMPS can cause significant discomfort and affect your ability to go about your daily activities. However, there are treatments available that can help. Keep reading to learn about them.

Several medications can help reduce nerve pain associated with PMPS. These come in two forms:

  • topical medications that you apply directly to your skin
  • oral medications that you take by mouth

Examples of topical medications used for PMPS include capsaicin and lidocaine.

Researchers found capsaicin, a chemical present in chili peppers, to be particularly promising. A 2021 research review found that capsaicin reduced overall pain and sharp or jabbing sensations associated with PMPS.

Doctors prescribe a few different types of oral medications to treat PMPS. These medications are typically used for other conditions, such as epilepsy and depression, but are also effective for nerve pain.

Examples of oral medications used for PMPS include:

Every individual experiences PMPS differently. What works to ease nerve pain for one person may not work for another. Due to this, you may need to check with a healthcare professional and try different types of medication for PMPS to find one that’s effective for you.

Nerve blocks involve the injection of a medication to prevent impulses from traveling along a specific nerve or nerve bundle. This reduces or stops pain in the associated area. Nerve blocks are a potential treatment for chronic (long-term) nerve pain.

For PMPS, a healthcare professional can identify the nerve or a nerve bundle that’s causing you pain. Guided by imaging, such as ultrasound, they can inject the anesthetic medication into this nerve or nerve bundle.

When healthcare professionals use nerve blocks for PMPS, they have the potential to reduce nerve pain significantly. One 2021 study of 350 nerve blocks for PMPS found that, on average, nerve blocks reduced pain by 56%.

Relief can last for weeks or months. In the study above, the average duration of pain relief was 45 days, and the median duration was 84 days. Over 69% of people in the study reported a reduction in their pain for at least 60 days.

Physical therapy is a type of treatment that helps boost strength, flexibility, and range of motion. A physical therapist can use a variety of exercises and techniques to help reach your health goals.

Physical therapy can also help manage pain and improve quality of life after an injury or surgery. Due to this, your healthcare professional may refer you to a physical therapist after your breast cancer surgery, whether or not you have PMPS.

Research suggests that physical therapy interventions benefit people with PMPS. For example, a 2022 review found that a variety of physical therapy techniques reduced pain and improved the quality of life in people with PMPS.

Having chronic pain can do a number on a person’s mental health. For example, dealing with chronic pain on a daily basis can lead to feelings of worry, frustration, or hopelessness.

Mental health conditions like anxiety and depression often happen alongside chronic pain. Because of this, some people with PMPS may benefit from doing psychotherapy, also called talk therapy, in addition to their other treatments.

A 2023 review of people with non-metastatic breast cancer concluded that psychotherapy improved psychological outcomes. Specifically, depression, anxiety, stress, and mood disturbances were reduced.

Research indicates that psychotherapy, particularly cognitive behavioral therapy (CBT), can help manage chronic pain. CBT can help you identify the thoughts and feelings that accompany your pain and teach you strategies to cope with them.

Surgery is typically only used for PMPS when other methods haven’t been effective at managing nerve pain. One of the reasons for this is that surgery carries a risk of not reducing nerve pain or potentially making it worse.

One type of procedure that surgeons may use is fat grafting. Fat grafting for PMPS aims to reduce pain from scar tissue that may have trapped nerves. It involves collecting fat from one part of your body and transferring it to the painful area.

A 2023 review of 266 people receiving fat grafting for PMPS found that the procedure significantly reduced PMPS pain. Improvements in quality of life were also reported.

Another type of surgery used is neuroma removal. A neuroma is an atypical growth of nerve cells at the site of an injury that can cause pain. If a neuroma is contributing to your PMPS, a surgeon can remove it by surgery.

Complementary and alternative medicine (CAM) therapies are used in addition to or instead of conventional treatments. A 2019 study found that 33% of individuals with a history of cancer reported using CAM in the past 12 months.

Investigators are investigating a variety of CAM techniques for treating chronic pain that happens after breast cancer treatment, including:

All of the above have evidence supporting their use for managing chronic pain, according to the National Center for Complementary and Integrative Health (NCCIH). They also point out additional CAM techniques that may help with chronic pain, such as:

What causes nerve pain following a mastectomy or breast-conserving surgery?

According to the American Cancer Society(ACS), PMPS happens due to damage to nerves in your chest or armpit during breast cancer surgery.

How common is nerve pain after a mastectomy?

Researchers estimate that 12 to 60% of people have nerve pain after breast cancer surgery.

How long does it take for nerve endings to heal after a mastectomy?

A 2024 review notes that nerve endings regenerate slowly at a rate of one millimeter (mm) each day. Regeneration starts about 4 weeks after surgery, with full recovery taking several months or potentially years.

How long do I need to wear a compression wrap after surgery?

You’ll likely need to wear a compression wrap for a few weeks after your surgery. The authors of one 2021 study recommend people to wear a compression bra for 6 weeks after surgery. Your surgeon will give you specific instructions.

Surgery is often part of a breast cancer treatment plan. It’s not uncommon to have nerve pain called PMPS after breast cancer surgery.

Several different types of treatment are available for PMPS. These include medications, nerve blocks, physical therapy, and more.

Before you have breast cancer surgery, it’s important to discuss the risk of complications like PMPS with your surgeon. They can give you a better idea of your individual risk and how you can manage PMPS if it does occur.