Pain in patients following treatment for breast cancer is common. Pain may result from surgical incisions, reconstructive surgeries, lymphoedema symptoms, radiotherapy side effects, joint stiffness, systemic therapies, axillary web syndrome, scar management, peripheral neuropathy, surgical induced hypersensitivities, disease in situ and metastatic disease may require specialised physiotherapy treatment. Common musculoskeletal issues include shoulder and scapulothoracic dysfunction in this population. Delayed or absent physiotherapy management for acute pain in breast cancer patients results in unsatisfactory outcomes for patients.
Many patients experience prolonged acute neuropathic pain arising from their incision sites, from nerve damage intra operatively or following radiotherapy. Acute neuropathic pain can benefit from physiotherapeutic intervention. In many cases it assists in resolution or modulation of this pain. Untreated acute neuropathic pain commonly progresses to chronic pain and also interferes with return to normal activity. This can prevent return to premorbid functioning and predisposes patients to other musculoskeletal complaints.
Additionally co-morbidities of a musculoskeletal or physical nature can amplify and complicate chronic pain. Chronic pain can also exacerbate other chronic health problems, limit capacity for physical fitness and reduce overall patient quality of life. Assessment and management of this patient group requires specialist physiotherapy skills and interventions to manage patients adequately. Chronic pain is burdensome and increases healthcare costs; timely physiotherapy intervention reduces this burden.
Physiotherapy techniques used to alleviate pain associated with breast cancer and its side effects will be discussed in this session along with relevant case examples.