Open heart surgery often causes discomfort in the chest, particularly around the sternum. This sternum pain is a normal part of the recovery process. Understanding its causes and progression can help individuals manage their recovery effectively.
Understanding Sternum Pain
The primary reason for sternum pain after open heart surgery is the sternotomy, a procedure where the breastbone (sternum) is cut down the middle to allow surgeons access to the heart. After the procedure, the two halves of the sternum are rejoined, typically using strong wires to hold them in place while they heal.
Pain also stems from direct trauma to the bone and surrounding tissues during the incision. Muscle soreness in the chest and back can occur as the body adjusts. Nerves in the area may become irritated or damaged, leading to sensations of pain, numbness, or tingling.
Expected Pain Duration
The timeline for sternum pain after open heart surgery typically follows a general trajectory, though individual experiences can vary. Initially, acute pain is highest in the first few days and weeks following surgery, and this is usually managed with prescribed medications. This early discomfort is a direct result of the surgical wound and the body’s immediate healing response.
Gradual improvement in pain levels becomes noticeable from approximately three to six weeks post-surgery. While pain may still be present, it generally lessens in intensity, particularly with careful movement. During this phase, the sternum begins to knit back together, with about 80% of the healing occurring within six to eight weeks.
Lingering discomfort can persist for several months, typically from two to six months after the operation. This might manifest as mild aches, stiffness, or tenderness, especially during specific activities, changes in weather, or with prolonged exertion. Some individuals may experience Post-Sternotomy Pain Syndrome (PSPS), where discomfort can last for years or reappear over time.
Full resolution of sternum pain can take up to a year or even longer for some individuals. While the sternum is largely healed within a few months, complete remodeling of the bone and soft tissues takes time. Factors such as age, overall health, the specific type of surgery performed, and pre-existing conditions can influence the individual healing period.
Coping with Sternum Pain
Managing sternum pain effectively is important for recovery after open heart surgery. Pain medication is key, with doctors prescribing stronger pain relievers initially, transitioning to over-the-counter options as pain subsides. Adhering to the prescribed schedule and dosage ensures consistent pain control.
Activity modification is crucial to protect the healing sternum and minimize pain. Patients follow “sternal precautions,” avoiding actions that strain the breastbone. This includes refraining from lifting objects heavier than 5 to 10 pounds, avoiding pushing or pulling with arms, and limiting overhead arm movements for several weeks.
Supportive measures provide additional comfort and aid healing. Using a pillow to brace the chest when coughing, sneezing, or moving helps stabilize the sternum and reduce discomfort. Gentle walking and other light, doctor-approved movements promote circulation and overall recovery, often as part of cardiac rehabilitation.
Emotional support and patience are valuable during recovery. The experience of pain and activity limitations can be challenging. Cardiac rehabilitation programs offer physical guidance and a supportive environment.
Recognizing Complications
While sternum pain is normal during healing, certain signs indicate a potential complication requiring immediate medical attention. An increase or worsening of pain after initial improvement is a significant red flag, suggesting an issue beyond typical healing.
Signs of infection at the incision site include redness, swelling, warmth, or discharge like pus. Fever or chills can also accompany an infection, which may be serious if it affects deep tissues around the sternum. These symptoms warrant prompt medical evaluation.
Clicking, popping, or grinding sensations from the sternum can indicate improper healing or loosened/broken wires. This condition, known as sternal non-union or instability, occurs in a small percentage of patients and causes persistent discomfort.
Persistent shortness of breath or new chest pain unrelated to the incision should also be reported immediately. These symptoms could signal other cardiac or pulmonary issues needing urgent assessment. Contacting the medical team promptly for any unusual signs or symptoms is important for patient safety.