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Lung diseases

Pain after Pneumothorax Surgery

11/02/2010

Question:

In the year 2009 I had 2 surgeries on my lungs to prevent a spontaneous pneumothorax. First one on the right lung, then one on the left lung. I of course experienced pain for a few months but around month 3 the pain went away and i felt completely normal.

However, around month 6 the pain started again. This time the pain is worse and is daily. X-rays show nothing but the pain is effecting my overall happiness and ability to enjoy simple things such as watching a movie.

My question is: Is it normal to experience lung pain 8 months after both successful surgeries? My lung has not collapsed since the surgeries, but every day I am reminded that my lungs are not normal.

Answer:

The current question involves a well reported topic of "post-thoracotomy" pain or pain after an incision in the chest wall.

Your course is within what has been described as changes of character or intensity of pain persisting after surgery.

A brief review of the literature suggests that 50% or more of patients who have such an incision, have persistent pain at least 1 year and beyond after their surgery. Although the exact reasons for changes in pain and persistence are not completely understood in all patients, the basis of the pain is the incision itself which cuts through nerves or areas of the chest wall adjacent to nerves. Subsequent healing and scar formation can have variable effects on the nerve function in these areas and the areas between the incision back along the path of the nerve returning to the spine. This pain usually does not imply any lung dysfunction per se.

The quality and intensity of the pain is variable and can range from none, to numbness, to significant persistent pain as you appear to have. The pain for many may decline over time but for some, it may not.

It is always important to discuss these findings with your physician. They may wish to get additional chest x-rays or CT scans to insure that the changes are not due to anything other than this "post-thoracotomy" pain. Although you describe some preliminary x-rays have not revealed abnormality.

You describe the pain as intruding into everyday activities suggesting that some type of additional treatment may be appropriate beyond watchful waiting. Discuss this with your physician as well.

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Response by:

Robert  Schilz, DO, PhD Robert Schilz, DO, PhD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University