Pain in the shoulder and breast area can sometimes be a consequence of breast cancer surgery or radiation therapy. Additionally, individuals might experience pain if the cancer has metastasized.
Pain in and around your scapula — the triangular bone on
either side of your upper back — is typically an orthopedic issue. However,
there are instances when it can be related to breast cancer. Read on to understand
more about the connection between breast cancer and shoulder pain.
Does Breast Cancer Make Your Shoulder Hurt?
When living with breast cancer, pain in your shoulder blade can result
from treatment. Cancer therapies can impact the scapula and other upper
back and arm structures, causing pain and potential injury. Nerves can also be
damaged, leading to persistent pain in different areas.
Post-treatment pain can limit your ability to lift your
arms, cause muscle strength loss, and make it harder to perform job-related or
leisure activities. Skeletal pain, such as shoulder pain, can also indicate
that cancer may have
spread from your breast to other areas of your body. If you’re experiencing
pain in one or both shoulder blades, it’s essential to discuss it with a doctor
or healthcare professional as soon as possible.
Shoulder Blade Pain After Breast Cancer Treatment
If you’ve undergone chemotherapy, radiation, or surgery, you
may experience pain around your shoulder blade due to the treatment. Here are
some common causes:
- Postoperative
Pain: Surgery, such as a lumpectomy,
can lead to pain during recovery. The more extensive your surgery is, the more painful
your arm and shoulder may feel.
- Postmastectomy
Pain Syndrome (PMPS): This chronic nerve pain is a common
disorder that develops in individuals who have had a mastectomy due to
breast cancer.
- Axillary
Web Syndrome: After breast cancer surgery, between 6% and 86%
of individuals may develop tight bands of fibrous tissue under their skin,
known as axillary
web syndrome. These bands can cause pain in the shoulder area when you
try to raise or extend your arm.
- Radiation-Induced
Fibrosis: Radiation therapy targets cancer cell DNA to halt growth but
can also affect surrounding tissues. Studies
show that it can alter the elasticity, or stretchiness, of the muscles in
the radiation area, leading
to pain and organ dysfunction.
- Scapula
Alata: After breast cancer surgery, the shoulder blade near the spine
may jut out, causing limited movement, swelling, and pain. Scapula alatae,
also called winging, typically resolves within a few months.
Depending on the cause, pain after breast cancer surgery may
persist for a while. Although it may diminish as you recover, many breasts
cancer survivors report
pain in their shoulder area years later.
Shoulder Pain and Breast Cancer Metastasis
Pain is not a common symptom of breast cancer. However,
breast cancer that has metastasized (spread to other body parts) can sometimes
cause shoulder blade pain. If you haven’t experienced shoulder pain related to
breast cancer before, or your doctor doesn’t believe it’s related to treatment,
it may be a sign the cancer has spread.
One of the most common locations for breast cancer
metastasis is in the bones. It’s also possible that pain near your right
shoulder could indicate that breast cancer has spread to the liver. This is
because some of the nerve networks around the liver originate
from the same nerves that attach near your right shoulder blade.
If it is a cancer relapse, treatment may help slow the
cancer’s growth, relieve your symptoms, and protect your bones.
What Does Shoulder Pain From Breast Cancer Feel Like?
The type of pain you feel usually depends on its cause. Some
people experience shoulder pain due to nerve damage from radiation therapy or
surgeries like lumpectomy, mastectomy, or lymph node removal.
If you have neuropathic pain,
you may feel a shooting or burning sensation. Some people describe the
discomfort as intense tingling or itching. You might also experience sharp pain
when you try to move your arms up or down. Swelling, stiffness, or numbness may
also be present.
If your pain is due to cancer that has metastasized, it might feel like a
deep, dull ache or cramp in your joints or bones. Pain near your right shoulder
blade could
suggest that your liver
is affected. You may also feel depressed or anxious, and the pain may disrupt
your sleep. Not getting enough sleep may exacerbate your pain.
How Do You Treat Shoulder Pain After Breast Cancer Treatment?
Reducing
shoulder pain after breast cancer treatment requires time, patience, and
support. Your cancer care team can offer guidance, especially the healthcare
professionals specializing in rehabilitation. Here are some therapies that may
help you:
- Manual
Therapy: A physiotherapist performs this hands-on treatment. It’s
particularly effective in helping drain fluid that can accumulate in the
arm (lymphedema) and mobilizing joints and tissues. Research indicates it
can help reduce pain and increase the range of motion.
- Therapeutic
Exercises: Active
therapeutic exercises can aid in recovery. Better results are seen
when people begin about 28 to 42 days
after surgery, once the risk of damaging drainage points has passed.
- Massage:
Once your wounds have healed, massage may help relieve pain and increase
your flexibility. A 2018 study
found that 30 minutes of targeted (chest and shoulder) massage twice a
week for eight weeks reduced the intensity of pain and increased
participants’ range of motion.
If these therapies or over-the-counter medications aren’t
sufficient to manage your pain, your doctor may prescribe opioid pain
medications or corticosteroids.
If you’re in pain due to cancer that has metastasized to your bones, your
oncologist can prescribe medications to slow the progression and help prevent
bone fractures.
The Takeaway
It’s common to experience pain in and around the shoulder
blade after breast cancer treatment. This pain may be related to surgery or
radiation therapy, which can affect the muscles, ligaments, and collagen fibers
in the treated area, making it harder to move your arm freely.
Less commonly, individuals may experience shoulder blade
pain if cancer has spread from the breast to other parts of the body,
particularly the liver and bones. If you need help regaining mobility in your
shoulder after breast cancer treatment, or if you’re still experiencing pain
after the postoperative period, it’s advisable to consult a doctor.
Medication, massage, therapeutic exercise, and manual
physical therapy can all help you feel and move better. Your healthcare team
can tailor a treatment plan to address your specific needs and help you manage
pain effectively.
Conclusion
Shoulder blade pain in breast cancer patients can stem from
various causes, including post-treatment effects or metastasis. Understanding
the connection between breast cancer and shoulder pain is essential for
managing symptoms and improving quality of life. By staying informed and
proactive in addressing pain, breast cancer survivors can find relief and
continue their journey toward recovery with greater comfort and confidence.
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