![]() You may be offered the opportunity to have a small injection of local anesthetic that may relieve the pain for a few hours by blocking the signals from the nerve(s). During your visit, the surgeon will listen to your description of your pain, and perform an examination designed to pinpoint the location of pain-causing, injured nerves. Our experience shows that injured nerves can be readily identified as the source of pain. These are very concerning statistics which highlight a significant problem! Nerve Pain Can Be Easily Identified in the Clinic Setting These patients often require opioid doses that approximate those doses taken by chronic opioid users, equal to six tablets of 5-mg hydrocodone per day. In a very large study of insurance data, over 10 percent of patients who had not previously taken narcotic pain medications continued to use them for more than 3 months after breast surgery. Post-Mastectomy Pain and Opioid Dependence However, these treatments are often insufficient due to incomplete pain relief, inconsistent administration, and adverse effects including chronic dependence (opioids), gastrointestinal distress (NSAIDs), and dizziness and fatigue (neuropathic drugs). Opioids, NSAIDs such as ibuprofen, and neuropathic drugs including gabapentin or amitriptyline are sometimes helpful in managing the pain to acceptable levels. Medication Treatments for Nerve Pain Often Not Enough Local anesthetic nerve blocks can confirm that the chronic pain is coming form the injured nerve(s). ![]() Altered sensation, including "pins and needles", shock-like, burning, or stabbing pain can provide evidence of nerve injury as a cause for the pain. These nerve injuries can lead to chronic pain due to the development of what are known as end neuromas, neuromas-in-continuity, and scar compression. When breast tissue is surgically removed from the chest, sensory nerves traveling through these tissues are transected, stretched, or caught up in scar during the healing process. This is not surprising, given that multiple small sensory nerves may be injured during breast surgery including mastectomy (the intercostobrachial nerve, pectoral nerves, and segmental intercostal nerves). Studies have demonstrated that sensory nerve injury provides a substantial contribution to post-mastectomy pain. Nerve Injury Contributes to Post-Mastectomy Pain Visit the peripheral nerve surgery page or contact our clinic at 73 to learn more about this option. Peripheral neve surgery may be an option for patients experiencing chronic post-mastectomy pain. Patients with chronic post-mastectomy pain can also experience significant discomfort from even minor sources like clothing, seat belts, or coughing. Therefore, post-mastectomy pain has far-reaching physical and psychological consequences. Our experience indicates that post-mastectomy pain can be similar in severity to that experienced by limb amputation patients, with average patient-reported pain scores of 8 out of 10. Even breast biopsy, lumpectomy, breast augmentation and breast reconstruction can result in chronic breast and chest pain. Long-term pain contributes to decreased work function, increased healthcare utilization, and increased depression risk. Studies have demonstrated that patients with post-mastectomy pain experience significantly worse quality of life with respect to physical well-being, physical autonomy, relationships, and psychological well-being. ![]() Reports indicate that 40 to 60 percent of patients who undergo mastectomy suffer from chronic pain - pain lasting longer than three months. ![]()
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