After your heart surgery, your focus is on healing and keeping your heart healthy. However, if you notice a burning or tingling sensation in your chest or arm, it can set off alarm bells. This could be a sign of neuropathy, a condition that sometimes occurs after cardiovascular surgery due to nerve damage. You may experience neuropathy depending on the type of surgical procedure you had and what incisions (cuts) were made.

This article will cover the basics of neuropathy and how it develops after heart surgery. We’ll discuss symptoms you may experience and offer ways to treat them. If you’re experiencing new nerve pain after cardiac surgery, talk to your health care team.

What Is Neuropathy?

Neuropathy is a condition that occurs when nerves are damaged, leading to pain or discomfort. The type of neuropathy you experience depends on which nerves are affected and how they were injured.

One of the most common forms is peripheral neuropathy. Cleveland Clinic estimates that 5 percent to 7 percent of people ages 45 and older have peripheral neuropathy. This type of neuropathy involves damage to nerves outside the central nervous system (CNS, the brain and spinal cord), impacting areas such as the arms, legs, or other parts of the body.

What Causes Neuropathy?

Nerves are made of highly specialized cells called neurons. They’re responsible for sending electrical signals between your brain and the rest of your body.

Peripheral neuropathy occurs when these nerves are damaged. A neuron has three parts — the cell body, axons, and dendrites. Myelin is a protective covering around axons that helps improve signal transmission. When one part of a neuron doesn’t work, it can’t send signals or it may send improper signals, causing feelings of pain without outside cause. Some types of neuropathy specifically target the axons or the myelin.

Neuropathy can have various causes, including trauma from surgical interventions such as heart surgery. During surgery, your surgeon makes cuts or incisions to get to your heart. This damages smaller nerves that need to heal over time. As they repair themselves, the nerves become especially sensitive.

What Are the Symptoms of Neuropathy?

Neuropathy symptoms will depend on which nerves are affected. Nerves transmit three types of signals:

• Motor — Signals that control movement
• Sensory — Signals the convey sensations, such as touch, sound, light, and pain
• Autonomic — Signals that regulate automatic body functions like blood pressure, bladder control, and sweating

Neuropathy from heart surgery typically affects the motor and sensory neurons.

Motor Symptoms

Motor nerves send signals from your brain to your muscles to control your movements. Neuropathy affecting these nerves leads to muscle weakness, making it harder to move. In severe cases, paralysis — the inability to move the affected body part — can occur.

When muscles don’t receive signals from the brain, they become smaller and weaker. This is known as atrophy. A loss in muscle strength can also lead to deformities, especially in the hands and feet.

Sensory Symptoms

Your peripheral nerves transform information from the outside world into nerve signals that travel to your brain. This allows you to perceive sensations like touch and pain. Peripheral neuropathy disrupts this process, altering what you feel or how those signals are communicated to your brain, which can blur or distort your senses.

For example, neuropathy may affect how you sense pain. Some people experience hyperalgesia — meaning they feel much more intense pain. The medical term “allodynia” refers to feeling pain easier than normal. The feeling of a shirt rubbing against your surgery site may be very painful. Under normal circumstances, this sensation usually wouldn’t bother you.

People recovering from heart surgery may also notice new tingling or numbness. This is common in the first few months after the procedure.

Nerve Pain vs. Chest Pain

MyHeartDiseaseTeam members know all too well that chest pain is a serious symptom. One member reached out to others with a question: “What’s the difference between nerve pain due to surgery through the chest wall and angina? I was told by my cardiologist that the pain I’m experiencing is nerve damage pain.”

Nerve pain near your incision is normal and should go away on its own as your nerves heal. However, if you begin experiencing chest pain like a tightness or squeezing, get medical attention right away. This pain is likely related to your heart and could indicate ischemia (restricted blood flow), which requires immediate care.

Why Does Heart Surgery Cause Neuropathy?

Several studies and case reports have found nerve damage after heart surgery.

During open heart surgery, the surgeon needs to cut open your sternum. This is the thick bone covering the center of your chest that protects your heart. When the surgeon pulls apart your sternum to access your heart, it can damage the intercostal nerves. These nerves run between your ribs to control your chest and abdominal muscles. Damage to your intercostal nerves can lead to neuropathy.

Previous research also shows that open heart surgery, such as valve surgery, can damage the ulnar nerve. This nerve runs from your shoulder down into your hand. A study from 1985 found that surgeons can damage the ulnar nerve if a person’s arm is positioned at their side during surgery. Moving the arm above their head reduces the risk of injury.

Symptoms of ulnar nerve damage from this study included numbness and tingling in the ring and pinky fingers. People also had muscle spasms in their affected arms.

Which Heart Surgeries Cause Neuropathy?

Open heart surgeries tend to cause neuropathy. This is because the surgeon needs to cut through many layers of tissue with nerves. Coronary artery bypass graft surgery (CABG) is a procedure used to treat heart disease. One small study found that around 38 percent of people recovering from a CABG had neuropathy, often affecting the ulnar nerve. Some of the cases were linked to factors such as sternum retraction (widening of the chest during surgery) and long cardiopulmonary bypass durations (extended time on a heart-lung machine).

One MyHeartDiseaseTeam member shared their story: “I had a CABG about 15 months ago where the left internal mammary artery was grafted onto the left coronary artery. Ever since, I’ve had constant pain around the area, not a deep pain. I went for tests and the cardiologist told me the pain was nerve damage.”

What Other Conditions Cause Neuropathy?

Surgery can physically damage nerves by cutting them, but several other health conditions can also lead to neuropathy. According to Cleveland Clinic, the most common cause of peripheral neuropathy is type 2 diabetes mellitus. Persistently high blood glucose (sugar) levels can damage nerves over time, often causing numbness and tingling in the lower legs and feet.

Other causes of neuropathy include:

• Vitamin deficiencies — Low levels of vitamin B, vitamin E, and copper all cause nerve damage.
• Alcohol use disorder — Alcohol in the bloodstream damages nerves, similar to diabetes.
• Certain medications — Cancer treatments like chemotherapy can be toxic to nerve cells.
• Autoimmune conditions — Too much inflammation attacks and damages the nerves.

What Should You Do if You Have Neuropathy After Heart Surgery?

If you're experiencing neuropathy after heart surgery, it’s important to consult your health care team. They can recommend medications and other strategies to help manage your symptoms. Common treatments for nerve pain include:

• Seizure medications like gabapentin or pregabalin, which reduce nerve signals to treat pain
• Certain antidepressant medications that also block nerve signals to control nerve pain
• Analgesic (pain-relieving medications) such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)

For neuropathy that doesn’t improve with standard treatments, other options include nerve blocks and steroid injections to help manage pain. Another option is cryoablation, a procedure that uses extreme cold to freeze damaged nerves, preventing them from sending pain signals.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their family members. On MyHeartDiseaseTeam, more than 61,000 members come together to discuss life with heart disease and share their experiences.

Have you had nerve pain after your heart surgery? How did your doctor manage it? What tips do you have for others dealing with neuropathy? Share your experience in the comments below or in a post on your Activities page.