Post Mastectomy Pain Syndrome
PMPS Background
Post-mastectomy pain syndrome (PMPS) is a chronic pain condition that can affect individuals following a mastectomy, which is the surgical removal of one or both breasts often performed as a treatment for breast cancer or for the prevention of breast cancer. While some discomfort is to be expected after any surgical procedure, this syndrome is characterized by persistent pain in the chest, armpit, and arm areas usually lasting more than six months following the operation.
The incidence of PMPS has been reported to be as high as 68% in some studies. The pain is often, but not always described as burning, stabbing, or throbbing and can be accompanied by sensations such as numbness, tingling, or itching. Understanding the causes of PMPS is essential for prospective patients as it can significantly impact their quality of life and daily functioning.
Causes of PMPS
The exact cause of PMPS is not entirely understood in every patient, but in many cases is related to nerve damage or nerve irritation that occurs during surgery and during the healing process.
Most women are completely numb after their mastectomy because the nerves that provide sensation to the breast tissue, breast skin and nipple/areolar complex are cut during this procedure. Unfortunately, in cases of patients with PMPS, it is thought that these nerves have regenerated in a disorganized fashion thus creating painful nerve ends (i.e., neuromas) that cause discomfort. Additionally, scar tissue formation, muscle tightness, and lymphedema (swelling caused by lymph fluid build-up) can contribute to the pain independently or by secondarily affecting the nerves mentioned above, resulting in symptoms. There are a number of risk factors for developing PMPS including the extent of the surgery, radiation therapy, and
individual pain sensitivity.
What Can I Do?
Managing PMPS initially involves a multidisciplinary approach tailored to the individual patient’s needs. Treatment options may include medications, physical therapy to improve mobility and reduce muscle tightness, or steroid injections that can provide targeted pain relief for some period of time. Some patients may also benefit from complementary therapies such as acupuncture, massage, or relaxation techniques to manage symptoms.
Unfortunately, in many cases, these more conservative modalities fail because of direct damage to the nerves themselves. In these cases, an evaluation with an experienced peripheral nerve surgeon can identify the problem with the help of diagnostic nerve blocks. If successful, an outpatient surgical procedure can be designed to address these neuromas and hopefully provide significant and permanent pain relief.
Dr. Peled has performed many operations on these very nerves. If you would like to learn more about this potential treatment option, please reach out to us to set up a consultation.
Real Patient Stories
The moment you realize your pain no longer controls your life is a profound one. Hear real patients describe their journeys and what it means to step into a life with reduced or no pain.
View Patient Stories
Are You Ready to Start Living Again?
If chronic pain is impacting your quality of life, you’re in the right place.
Request A ConsultationJoin Our Growing Community: Support, Resources & Real Conversations
Navigating chronic pain can feel isolating. You don’t have to do it alone.
Dr. Peled is active in several online nerve pain communities, particularly those focused on specific conditions, such as occipital neuralgia. He shares general advice, answers questions, and provides support for those seeking clarity about their condition.
Explore our blog, follow us on social media, or connect with us through one of the online forums on Facebook or Reddit.
Join The Conversation
Follow our socials for more behind-the-scenes content from the team and Dr. Peled.
