Pain from cancer and its treatment

What causes cancer pain

Cancer pain is not one condition. It is pain linked to cancer in some way. It can be caused by:

The cancer itself, for example a tumour pressing on nerves, bones or organs, or cancer that has spread to the bones
Treatment, such as nerve damage from chemotherapy, scar tissue or nerve injury after surgery, or late effects of radiotherapy
Other things, such as infections, constipation, or tight muscles from changes in how you move

Almost 3.5 million people are living with cancer in the UK, and more people than ever are living for many years after diagnosis. Macmillan estimates that around 1 in 4 people with cancer live with long-term effects of the cancer or its treatment. For some, that includes pain that affects their ability to work.

Pain can almost always be eased. Telling your team about it is not complaining, and it does not always mean the cancer is getting worse.

Types of pain

Knowing the type of pain helps your team choose the right treatment. You may have more than one type.

Chemotherapy nerve damage

Also called chemotherapy-induced peripheral neuropathy (CIPN). Numbness, tingling, burning or shooting pain, usually in the hands and feet. Linked to some chemotherapy and targeted drugs, such as platinum drugs, taxanes and vinca alkaloids.

Pain after surgery

Most surgical pain settles within days or weeks. But some people get long-term pain from nerve damage or scar tissue, for example after breast, chest or limb surgery. It can feel sharp, burning or very sensitive to touch.

Pain after radiotherapy

Can start months or even years after treatment. It may come from stiff, scarred tissue, nerve damage or weakened bones in the treated area, such as the pelvis.

Bone pain

A dull, constant ache that is often worse when you move. It can happen when cancer spreads to the bones.

Nerve pain

Burning, tingling, stabbing or shooting pain, from a tumour pressing on nerves or nerve damage from treatment. It often needs different medicines from other pain.

Soft tissue pain

Pain from damage or pressure in organs or muscles, for example an aching tummy from a swollen liver.

Breakthrough pain

A sudden flare of pain even though you take regular painkillers. It may need a fast-acting medicine as well as your usual one.

Phantom pain

Pain or feelings in a part of the body that has been removed, such as a limb or breast.

How pain changes over time

Pain linked to treatment often follows a pattern. Everyone is different, so use this as a rough guide.

During treatment

Short-term pain

Pain from surgery, sore skin from radiotherapy, or early tingling from chemotherapy. Usually managed by your cancer team.
Weeks after chemotherapy

Coasting

Nerve damage can get worse for a few weeks after a chemotherapy drug is stopped, before it starts to improve.
Months to years

Recovery

Nerves heal slowly. Nerve and surgical pain often ease over several months or longer. For some people they don't go away completely.
Months to years after

Late effects

Some effects, especially of radiotherapy, can start long after treatment ends. Pain that lasts more than 3 months is called chronic or persistent pain.

Always report new pain after cancer, even years later. It is usually not the cancer coming back, but it should be checked.

When to get urgent help

If you are having cancer treatment, you should have a 24-hour hospital contact number (often called an acute oncology or chemotherapy helpline). Keep it on your phone and by your bed.

Call your 24-hour cancer line now, or 999 or A&E if you can't get through, if you have

a high temperature, or feel hot, cold, shivery or suddenly unwell during chemotherapy. This could be neutropenic sepsis, which can be life-threatening
new back or neck pain, especially pain like a band around your chest or tummy, or pain worse when lying flat, coughing or sneezing
weakness or numbness in your legs or arms, or difficulty walking
problems controlling your bladder or bowels
chest pain or sudden breathlessness

Call your cancer team or NHS 111 if

your pain is not controlled by your painkillers
you have a new, severe or different pain
you have a painful, hot or swollen arm or leg
side effects of painkillers, such as constipation or sickness, are making you unwell

See your GP or cancer team if

you have numbness, tingling or pain in your hands or feet
you have ongoing pain in a scar, the treated area or your joints
you have bone pain or aching that doesn't go away
pain is affecting your sleep, mood or work

Spinal cord compression is an emergency

Cancer that spreads to the spine can press on the spinal cord. More than 9 in 10 people with this have back or neck pain first. Treatment is usually needed within 24 hours of diagnosis to prevent lasting damage. Tell the person you speak to: "I have cancer and I am worried about spinal cord compression."

Getting your pain assessed

During treatment, your cancer doctor, specialist nurse or GP will usually manage your pain. After treatment, your GP is often the first person to see, but you can also contact your cancer specialist nurse.

To find the cause, your team will ask where the pain is, what it feels like, how strong it is and what makes it better or worse. You may need scans or blood tests.

If pain is complex or hard to control, you can be referred to a hospital pain team, a specialist palliative care team (they help with symptoms at any stage, not only at the end of life), or a late effects clinic where these exist.

Up to 18 weeks

The maximum NHS waiting time in England from referral to starting non-urgent consultant-led treatment, such as at a chronic pain clinic. Urgent cancer care follows faster targets. Many pain clinics have longer waits in practice.

Treating pain

Most cancer pain can be well controlled. Often a mix of treatments works best. Many painkillers work best when taken regularly, rather than waiting until pain is bad.

Simple painkillers

From a pharmacy, or prescribed

Paracetamol and anti-inflammatories such as ibuprofen. Check with your cancer team first during chemotherapy, as some can hide a temperature or affect bleeding.

Opioid painkillers

Prescription from your GP or cancer team

Weaker ones such as codeine, and stronger ones such as morphine or oxycodone. They come as tablets, liquids, patches or injections. Drowsiness often settles after a few days. Constipation is common, so you will usually need a laxative too.

Nerve pain medicines

Prescription

For chemotherapy nerve damage, duloxetine is the medicine with the best evidence. Gabapentin, pregabalin and amitriptyline are also used. They usually need a few weeks to work, and the dose is often built up slowly.

Creams and patches

Prescription, or from a pharmacy

Menthol cream or a high-strength capsaicin patch can ease nerve pain in one area. A capsaicin patch is applied in clinic and can work for up to a few months.

Other medicines

Specialist cancer or palliative care team

Steroids can reduce swelling around a tumour. Bone-strengthening medicines can help bone pain.

Radiotherapy for pain

Cancer team (oncologist)

A short course of radiotherapy can ease pain from cancer in the bones. Pain often starts to ease within a few weeks.

Nerve blocks

Hospital pain team

An injection to numb or block a nerve, for pain that other treatments haven't controlled. The effect can last weeks or months.

Strong painkillers and driving

It is an offence to drive if a medicine affects your driving. Strong opioids and some nerve pain medicines can make you drowsy, especially when you start them or change the dose. Ask your pharmacist. Don't stop any regular painkiller suddenly without advice.

Specialist and rehab services

Getting back to everyday life, including work, often needs more than medicines. Ask your cancer team or GP about these.

Physiotherapy

Often a block of sessions over 6 to 12 weeks

Exercises to restore movement after surgery, ease shoulder and scar pain, and improve balance if you have numb feet. Some areas run cancer rehab or exercise programmes.
Occupational therapy

Assessment, then follow-up as needed

Practical help with fatigue, pain and daily tasks, plus equipment and advice for returning to work.
Lymphoedema services

Ongoing support

If surgery or radiotherapy causes swelling in an arm, leg or other area, a lymphoedema specialist can help with compression garments, massage and skin care.
Pain clinic and psychological support

By referral. Waits vary

For long-term pain after cancer, a pain clinic can offer other treatments, TENS, acupuncture in some areas, and pain management programmes. Talking therapies can help with the worry and low mood that often come with pain.

Self-help

If you have numb or painful hands and feet

Check bath water with your elbow, as you may not feel heat
Wear gloves and warm socks in cold weather
Wear well-fitting shoes and check your feet for cuts
Keep floors clear and rooms well lit to avoid falls
Use gloves for gardening and washing up

Living well with pain and fatigue

Take regular painkillers on time, not just when pain is bad
Gentle activity, such as walking, can ease fatigue
Pace yourself and spread tasks across the week
Try heat, cold, relaxation or mindfulness
Keep a regular sleep routine

Getting the best care

Tips for appointments

Keep a pain diary: where it hurts, how strong it is out of 10, what it feels like and what helps
Mention numbness or tingling early in chemotherapy. Your team may change your treatment to protect your nerves
Say if your painkillers aren't working or cause side effects. There are usually other options
Ask who to contact about pain after your treatment has finished
Ask about a referral to a pain team, palliative care or rehab if pain is hard to manage
Ask for a written summary of your treatment, so future doctors know what you've had

Cancer and work

Under the Equality Act 2010, cancer automatically counts as a disability from the day you are diagnosed. You stay protected even after treatment ends and you are in remission. (The Disability Discrimination Act gives similar protection in Northern Ireland.)

This means your employer must not treat you unfairly because of cancer, and must make reasonable adjustments. These might include:

A phased return to work
Flexible hours and extra breaks
Working from home some days
Time off for treatment and check-ups
An ergonomic chair and well-set-up workstation
Voice recognition software if your hands are painful or numb
Lighter duties or a change of role for a while
A parking space close to the entrance

Access to Work is a government grant that can pay for equipment, a support worker or taxis to work if you can't use public transport. It doesn't have to be paid back. Macmillan, Acas and Citizens Advice can advise on your rights.

Benefits

You may be able to get Statutory Sick Pay while off work, and Personal Independence Payment (PIP), or Adult Disability Payment in Scotland, whether or not you work. Universal Credit and Employment and Support Allowance may also help. People with cancer in England get free prescriptions with a medical exemption certificate. Macmillan's money advisers and Turn2us can help you check what you can get.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:

A private consultation with a pain specialist
A course of physiotherapy or cancer rehab from a registered practitioner
Acupuncture or a TENS machine recommended by your clinician
Compression garments or aids recommended by your lymphoedema or therapy team
Workplace or home equipment, such as an ergonomic chair, voice recognition software or daily living aids

We fund treatment, equipment and support for getting back to work, not general living costs or cancer treatment itself. Prices vary, so always get a written quote to include with your application.

Apply for funding Check the requirements

Support and sources

Macmillan Cancer Support

Information, money and work support

Support Line 0808 808 00 00, 7 days a week, 8am to 8pm. Nurses, money advisers and work support.

macmillan.org.uk

Maggie's

Free cancer support centres

Drop-in centres across the UK with support for pain, fatigue, money and work. Call 0300 123 1801.

maggies.org

Cancer Research UK

Health information

Nurse helpline 0808 800 4040, Monday to Friday, 9am to 5pm. Information on coping with pain.

cancerresearchuk.org

Sources for this guide

Last reviewed: October 2026.