Persistent pain can be a problem for about 1/3 of individuals who have had a mastectomy or lumpectomy. (1) Often when pain lasts longer than expected after breast surgery it is called “Post Mastectomy Pain Syndrome” (PMPS). One such cause of PMPS is thought to be nerve injury as a result of the surgery, however, there may be other factors that contribute to PMPS. One commonly considered cause of persistent pain after breast surgery is myofascial pain. (1, 2). This type of pain is due to issues in the muscles, connective tissue, or fascia. Myofascial trigger points are localized painful spots in the muscle within a tight band in the muscle. Most often myofascial pain is related to these active myofascial trigger points. These trigger points can be painful if compressed or over stressed and can also cause referred pain (6).
A 2010 study found that 44% of women who had breast cancer surgery developed myofascial pain at a one year follow up (2).
Another study (3), found significantly more active trigger points in the neck and shoulder muscles of women who had breast cancer surgery compared to women who had breast cancer but did not have surgery. This helps understand the possible link there may be between myofascial trigger points and breast cancer surgery.
While medication is often used to help manage PMPS, physiotherapy can also play an important role in reducing myofascial pain. There is good research to suggest that stretching, strengthening, and cardiovascular exercise, as well as hands-on treatments such as myofascial release, dry needling, acupuncture, and transcutaneous electrical stimulation (TENS) can be very effective in helping reduce myofascial pain (4,5,6,7,8,9). Physiotherapists also offer information, posture corrections, and ergonomic modifications as part of the overall treatment planning to help with PMPS. A physiotherapist with experience and expertise in treating cancer related pain can be a great addition to your cancer care team. They can help you understand your pain and assist you in navigating the health care system with respect to oncology.
Persistent pain following breast cancer surgery is not only common, but also concerning to those affected by it. PMPS can cause functional limitations and could possibly impact quality of life. If you or someone you know has ongoing pain after breast cancer surgery it is important to determine what is the cause of your pain. If there is a myofascial component to your pain after breast surgery, physiotherapy can help.
If you are experiencing cancer related pain or concerns, please make an appointment with our women’s health & cancer rehab physiotherapist, Susan Bocchinfuso: https://lakeviewphysio.janeapp.com/locations/lakeview-physio-clinic/book#/staff_member/69