A common cause of pain during and after Breast Cancer treatment and a treatment option:
Up to 45% of those undergoing or post breast cancer treatment have pain. Usually, this pain is in the upper limb or mid-back region. It is generally thought that this pain is due to a myofascial trigger point, or areas of hyper-irritable spots in the skeletal muscle. These spots continually contract and/or become fibrotic. These spots are painful and cause muscle dysfunction around them and gradually increase pain in the area.
The myofascial matrix of the body is the area where muscle and fascia integrate. The myotendinous zone is where muscle and tendon integrate. There are weaker tissue connections and many nerve fibers at transition zones in the body. The myofascial area can become very painful. This is especially true if a faulty spot, or trigger point, is created.
Trigger points not only are extremely tender and painful in and of themselves, but they also refer pain. As well, they can cause distant motor and autonomic or sensory effects. For example, a trigger point in the sternocleidomastoid muscle (front of the neck) can cause headaches that move to the crown.
Common areas of trigger points and pain in breast cancer patients include the upper trapezius muscle, pectorals, serrates anterior, and some shoulder muscles. In addition to being painful, the neck, mid-back, shoulders, and scapular areas may become stiff.
Treatment is possible and generally safe. First-line treatment should be with a physical therapist. These professionals have a variety of techniques to treat muscle and fascial pain. A good physical therapist will create an individualized program to include stretching, massage, deep tissue work, strengthening, and passive relief modalities for the patient. If physical therapy is not successful or fast enough, a physician can perform trigger point injections with a numbing medication and/or anti-inflammatory. These injections are directed into the painful trigger point itself.
Insurance covers both therapy and physician trigger point injections and treatments. In many states, including Louisiana, there is a provision to allow direct access to a therapist for patients.