Long-Term Pain After Nephrectomy: What to Expect

Having a kidney removed is a big deal. Whether you had a nephrectomy for kidney cancer, severe kidney disease, or as a living donor, you’ve gone through major surgery. So if you’re months out from your operation and still thinking, “Why does this still hurt?” you’re not alone and you’re not imagining it.

While most people see pain improve steadily in the first few weeks, some develop long-term or chronic pain after nephrectomy. Understanding why it happens, what’s “normal,” and when to call your care team can make this phase a lot less scary. Let’s walk through what to expect from long-term pain after nephrectomy, and what you can do about it.

What Exactly Is a Nephrectomy?

A nephrectomy is surgery to remove all or part of a kidney. It can be:

• Radical nephrectomy: Removes the entire kidney, often for cancer.
• Partial nephrectomy: Removes just the part of the kidney with a tumor or damaged tissue.
• Open nephrectomy: Uses a larger incision, usually along the side or abdomen.
• Laparoscopic or robotic nephrectomy: Uses small “keyhole” incisions and a camera.

Regardless of the technique, your surgeon has to work around muscles, ribs, nerves, and major blood vessels. It’s no surprise your body has something to say about that afterwards often in the form of soreness, stiffness, or sharper pain.

In the short term, it’s normal to have pain around your incision, soreness when you cough or take a deep breath, and general fatigue. Most people are told to avoid heavy lifting and strenuous activity for at least 4–6 weeks after surgery while tissues heal.

Is Long-Term Pain After Nephrectomy Normal?

Short answer: some ongoing discomfort is common, but intense or worsening pain months later deserves attention.

Doctors often define chronic postsurgical pain as pain that:

• Lasts more than 3 months after surgery
• Started with the operation (it wasn’t a problem before)
• Can’t be fully explained by another condition like an obvious hernia or infection

Studies suggest chronic pain after nephrectomy is not rare. Research on open nephrectomy has found persistent pain in a noticeable portion of patients in the months after surgery, with many people improving by 6 months. Other studies on laparoscopic living donor nephrectomy report chronic pain in a smaller percentage of patients, but it can still significantly affect daily life for those who experience it.

The good news? For most people, pain:

• Improves gradually over weeks to months
• Becomes less intense and less frequent
• Responds to treatment when you and your care team tackle it proactively

If you’re several months out and still struggling, it doesn’t mean anything “went wrong” but it does mean it’s worth talking openly with your surgeon, nephrologist, or primary care provider.

Common Types of Long-Term Pain After Nephrectomy

Not all post-nephrectomy pain feels the same, and different patterns give your care team clues about what’s going on.

1. Incisional and Muscle Pain

This is the classic “surgery pain”:

• Aching or pulling along your scar
• Tightness when you twist, roll over, or stand up
• Soreness in the abdominal or flank muscles that were cut or stretched

Even after the skin looks healed, deeper tissues and muscles continue to remodel for months. Scar tissue can feel stiff, lumpy, or tender. Some people notice:

• Pain with certain movements, like reaching overhead or bending
• “Tugging” or pulling if they move quickly
• Fatigue in core muscles on the surgical side

Gentle stretching, core-strengthening guided by a physical therapist, and gradual activity can help this type of pain improve over time.

2. Nerve-Related (Neuropathic) Pain

Nephrectomy is performed near key nerves that run between your ribs and along your abdominal wall. During open or laparoscopic surgery, these nerves can be stretched, irritated, or rarely cut. When that happens, you may develop neuropathic pain, which feels different from simple muscle soreness.

Nerve-related pain may feel:

• Burning, electric, or “zinging”
• Like pins and needles or numb patches around the incision
• Worse when you touch the area lightly, or when clothing rubs against it

Some people also notice a flank bulge or “pseudo-hernia” on the surgical side. This can happen if nerve injury weakens a section of the abdominal wall muscles, making them less able to hold the area flat. It may look like a soft bulge rather than a true hernia with tissue pushing through a hole in muscle.

Neuropathic pain often needs different treatments than typical incisional pain, including medications that calm irritated nerves or procedures such as nerve blocks.

3. Referred Pain

Some pain after nephrectomy shows up in unexpected places. For example:

• Shoulder pain can appear after laparoscopic surgery because gas used in the abdomen can irritate the diaphragm and nearby nerves, which your brain sometimes interprets as shoulder pain.
• Back pain can show up if your posture changes while you’re guarding your incision or moving differently to avoid discomfort.

Referred pain usually improves as the body clears trapped gas, as inflammation cools down, and as your movement patterns normalize.

4. Pain From Complications

Persistent or worsening pain can occasionally signal a complication, such as:

• Wound infection (redness, warmth, pus, fever)
• Hernia at the incision site
• Urine leak or fluid collection near the kidney bed
• Blood clots or other internal issues

This is one big reason to keep your care team in the loop instead of just “toughing it out.”

Why Does Long-Term Pain After Nephrectomy Happen?

Chronic post-surgical pain is complex, and often more than one factor is involved. Some key contributors include:

Nerve Injury or Irritation

Surgical tools, retractors, or ports can put pressure on or stretch nerves near the incision. In some cases, a nerve can be cut or trapped in scar tissue. When nerves are injured, they can:

• Send extra “danger” signals to the brain, even after tissues have healed
• Become overly sensitive so that normal touch feels painful
• Cause numb areas that are also strangely tender at the edges

Severity of Early Postoperative Pain

Research on many types of surgery has found a pattern: people who have very severe, poorly controlled pain in the days right after surgery are more likely to develop chronic pain later. The nervous system can become “wound up,” and pain pathways may stay overactive.

Surgical Technique and Incision Location

Open flank incisions tend to disturb more muscle and nerves than small-port laparoscopic or robotic approaches. That doesn’t mean laparoscopic surgery can’t cause long-term pain, but risk patterns may differ. The exact location and size of your incision, and how much tissue had to be moved to reach the kidney, all play a role.

Individual Factors

Everyone’s pain system is different. Factors that may influence long-term pain risk include:

• Younger age
• History of chronic pain conditions (like back pain, migraines, or fibromyalgia)
• Anxiety, depression, or high stress around the time of surgery
• Longer hospital stays or complications

None of these mean you’re “too sensitive” or that pain is “in your head.” They just help explain why some nervous systems hang onto pain signals longer than others.

When Is Long-Term Pain a Red Flag?

Call your surgeon or healthcare team promptly if you notice:

• Pain that suddenly gets much worse after it had been improving
• Fever, chills, or feeling unwell
• Redness, warmth, or drainage from your incision
• New or worsening swelling in your belly or groin
• Difficulty urinating, blood in your urine, or sudden decrease in urine output
• Shortness of breath, chest pain, or new leg swelling (possible blood clot or lung issue)
• Pain so bad you can’t sleep, walk, or take deep breaths even with medication

These symptoms don’t always mean something serious is wrong, but they should always be checked.

How Long Can Post-Nephrectomy Pain Last?

Everyone heals at their own pace, but general patterns look like this:

• First 1–2 weeks: Pain is usually at its peak and gradually improves with medication and rest.
• Weeks 3–6: Many people transition to milder pain, soreness with movement, and fatigue.
• 6–12 weeks: Most people can resume normal daily activities and light exercise, although heavy lifting may still be limited.
• After 3 months: Any ongoing pain is considered “long-term” or “chronic” and may need a more targeted plan.

For some, lingering pain is mild an occasional twinge when they overdo it or sleep in a strange position. For others, the pain is more persistent and can interfere with work, exercise, or sleep. If you’re in that second group, you deserve more help than “it just takes time.”

How Doctors Can Help Manage Long-Term Pain

You don’t have to manage chronic pain after nephrectomy on your own. A tailored pain plan might include several of the following:

1. Medications

Depending on your kidney function and overall health, your provider may consider:

• Acetaminophen for baseline pain control
• Nonsteroidal anti-inflammatory drugs (NSAIDs) in select patients whose remaining kidney can safely handle them
• Neuropathic pain medications such as gabapentin, pregabalin, or certain antidepressants that calm overactive nerves
• Topical treatments like lidocaine patches over hypersensitive scars (if your provider okays it)

Opioids may be used briefly after surgery, but they’re rarely a good long-term solution due to side effects and dependence risks.

2. Physical Therapy and Rehabilitation

A physical therapist familiar with post-abdominal surgery can:

• Teach gentle stretches to reduce stiffness
• Help rebuild core and back strength safely
• Correct posture changes that may be feeding into back or flank pain
• Use techniques like scar mobilization or desensitization for tight, tender scars

The goal is not to “push through” pain, but to gradually retrain muscles and nerves so movement becomes more comfortable again.

3. Nerve Blocks or Other Procedures

For stubborn nerve pain, a pain specialist or anesthesiologist may offer:

• Intercostal or subcostal nerve blocks to numb irritated nerves
• Trigger point injections for tight, painful muscle knots
• Other targeted treatments depending on imaging and exam findings

These procedures don’t always provide permanent relief, but they can “reset” pain pathways enough to make rehab and daily life easier.

4. Mind–Body and Behavioral Strategies

Chronic pain affects your mood, sleep, and stress levels and those factors, in turn, influence how much pain you feel. Helpful tools can include:

• Cognitive behavioral therapy (CBT) for pain
• Relaxation techniques, meditation, or breathing exercises
• Support groups, especially for kidney cancer survivors or living donors

None of these say “it’s just in your head.” They acknowledge that the brain and nervous system are part of the pain story, and that retraining them can reduce suffering.

Living With One Kidney and Long-Term Pain

The big picture: most people can live a full, active life with one kidney. The remaining kidney usually adapts and does the work of two. Your care team will likely monitor:

• Blood pressure
• Kidney function tests (like creatinine and estimated GFR)
• Urine tests for protein or other changes

While you’re working through long-term pain, it helps to treat your body kindly:

• Stay hydrated as advised by your provider.
• Follow any medication restrictions that protect your kidney.
• Build movement back slowly, starting with short walks.
• Prioritize sleep and stress management both affect pain levels.
• Speak up early if something feels off instead of waiting for it to get “bad enough.”

Think of this as a long recovery chapter, not the whole book of your life with one kidney.

The Bottom Line

Long-term pain after nephrectomy is real, and it’s more common than many people expect. Hours of surgery, nerve irritation, muscle disruption, and your body’s own healing response can all contribute. Most people gradually improve within months, but if your pain is sticking around, getting worse, or interfering with daily life, it’s time for a deeper conversation with your care team.

You deserve a clear plan: ruling out complications, addressing nerve pain, rebuilding strength, and supporting your mental and emotional health. This isn’t about “just living with it.” It’s about helping you heal as completely as possible body and mind after a major surgery.

Real-Life Experiences: What Long-Term Pain After Nephrectomy Can Feel Like

Every person’s story after nephrectomy is unique, but hearing how long-term pain can show up in real life may help you feel less alone. The following examples are composites based on common patterns patients report not actual identifiable individuals.

Case 1: The Surprise “Good Day, Bad Day” Pattern

Imagine someone in their 50s who had a laparoscopic nephrectomy for kidney cancer. By three months after surgery, they’re back at work and mostly off pain medication. Life is “normal” on paper but reality feels messier.

On good days, they barely notice their side. On bad days, especially after a long meeting at a desk or a rushed grocery run, they feel a deep ache along the incision line. Rolling over in bed can send a quick stab of pain through the flank. They’re not doubled over, but they’re constantly aware of that side like a background notification that never quite goes away.

Once they mention it to their provider, they’re referred to physical therapy. There, they discover their core muscles on the surgery side are weaker and their posture has shifted to “protect” the incision. With targeted exercises and gentle stretching, their pain frequency drops, and the bad days become much rarer.

Case 2: The “Burning Patch” That Just Won’t Quit

Another person, a younger adult kidney donor, feels proud about donating but frustrated by a strange patch of burning pain near their incision. Even months after surgery, light touch from clothing, seatbelts, or even a hug can trigger sharp, electric jolts. There’s also a small area of numbness that feels weirdly “dead” and painful at the same time.

At first, they assume this is just normal healing. Eventually, they bring it up at a follow-up appointment and learn it’s likely neuropathic pain from a small nerve injury. Their provider prescribes a nerve-calming medication and suggests desensitization techniques gently rubbing different textures across the area to help the nerve and brain “relearn” normal sensation. Over time, the burning becomes less intense, and while the numb spot doesn’t fully disappear, it becomes much less bothersome.

Case 3: The Quiet Emotional Toll

A third person, recovering from a radical nephrectomy, never needed intense pain meds after surgery. Their physical pain is mostly low-grade a tug here, a twinge there but the emotional impact is big. They worry about their remaining kidney, watch every ache closely, and feel anxious when they feel tired or sore. Sleep is patchy, and on stressful days, the pain seems louder.

Once they share these concerns with their care team, they’re connected with a counselor who specializes in chronic illness and cancer survivorship. They learn relaxation techniques, challenge catastrophic thoughts, and slowly rebuild trust in their body. Their pain doesn’t magically vanish, but it becomes one part of their life instead of the center of every thought.

What These Experiences Share

These stories have a few things in common:

• Pain looks and feels different for everyone.
• People often wait months before telling their provider how much pain is affecting them.
• Once they speak up, there are usually more options than they expected from physical therapy to medications to emotional support.

If you recognize pieces of your own experience in these examples, consider it your sign to ask for help. You’re not being dramatic. You’re advocating for yourself and that’s a crucial part of healing after nephrectomy.