Free Rotator Cuff Health Check
In celebration of National Physical Therapy Month and Breast Cancer Awareness Month in October, Orthopedic and Balance Therapy Specialists will host a FREE Rotator Cuff Health Check-Up Event on the following dates and locations:
- Monday October 17, 2016 at our Valparaiso office
- Tuesday October 18, 2016 at our Crown Point office
During the event, each attendee will receive:
- Know which rotator cuff muscle is affected and the grade of the tear
- Correct the cause of your pain and speed up the healing process
- Prevent your shoulder from getting worse
We have 24 FREE consultation spots available for each location. To hold your spot, please call 219-202-2500 in Valparaiso, or 219-203-3100 in Crown Point.
Stiffness And Diffuse Pain
More common than nerve pain is stiffness and diffuse pain. I have read estimates that up to 60% of women with breast cancer experience some degree of shoulder discomfort. A common cause is the limited range of motion that most of us experience immediately after surgery. We are given exercises, remember the crawling up the wall one, but not everyone does them as often as could help. Additionally, we are given instructions about what not to do we are limited in what we can lift and the physical exercise in which we can engage. Those directions are variable, depending on the kind of surgery. Women who undergo breast reconstruction are going to be much more limited in recovery than those who have a wide excision. If we don’t pretty quickly regain our usual range of motion , more stiffness or even frozen shoulder and rotator cuff issues can result.
Breast Cancer In The Elderly
Breast cancer risk increases with age. A third of women diagnosed are older than 70! Cancer risk in general increases with age, and breast cancer is no exception. If youre a caregiver for an aging relative, make sure they receive proper screenings. Teach them the signs of breast cancer so they know what to look for.
Fortunately, the rate of breast cancer in women over 50 has been going down in recent years. Yet, as the population ages, the number of older women with breast cancer will continue to be high.
There is no one-size-fits-all approach to treating breast cancer in the elderly. Cancer treatments include surgery, radiation, and chemotherapy. Doctors often use a combination of these treatments for a single case of cancer. These treatments are hard on the body. Doctors must consider their patients ability to handle treatment when developing a plan.
Older patients are more likely to experience treatment side effects than younger patients. Sometimes, minimal treatment may be the best option. This may be the case if the cancer is not aggressive and the patient has other health conditions. This is a growing area of research and different doctors have different approaches. Your loved one may want to discuss treatment options with a few different doctors to find a treatment plan that makes them most comfortable.
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What Is Frozen Shoulder
Frozen shoulder is so named because it causes the shoulder to stiffen, reducing its mobility and making it feel like its frozen in place. Doctors dont know exactly what causes it, but they know that when it occurs, it is often the result of a problem in the joint capsule.
Fractures and overuse injuries like bursitis and tendinitis can lead to inflammation and a thickening of the connective tissues around the main shoulder joint. These tissues and tendons from the joint capsule that surrounds the joint and, as they become inflamed and scarred, they get stiff and lose their capacity to stretch.
This results in pain that, in turn, makes the patient less likely to move the shoulder. However, the lack of movement only makes the situation worse, further contracting the tissues. As the capsule tightens and shrinks, the shoulder joint has less room to move in, and the lubricating synovial fluid inside the joint capsule can become depleted.
Without treatment, bands of scar tissue form between the joint capsule and the bone, further limiting movement. The condition takes time to develop, with stiffness and range of motion gradually becoming worse over a period of three stages:
The following factors increase the risk of experiencing frozen shoulder:
Breast Cancer And Shoulder Blade Pain
Some women may feel back pain in the upper back between the shoulder blades before any other sign of breast cancer reveals itself. The discomfort is usually attributed to muscle pain, inflammation of the spine or stretching the tendon and ligaments in the back.
Its important to know that tumors will sometimes develop deep within the breast tissue of the chest and felt in the spine or ribcage. There is also the possibility of metasis, a malignant spreading of the disease to the ribs or spine.
For example, The National Breast Cancer Foundation reports about a patient who was diagnosed with metastatic breast cancer and suffered from a severe back pain.5
The Journal of the Canadian Chiropractic Association reported that metastatic bone disease secondary to breast cancer is a common cause of low back pain. The report stressed the need for further imaging in patients with a history of breast cancer and whose physical examination and plain film radiographs are inconclusive or suspicious.6
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Common Causes Of Shoulder Pain
Most cases of shoulder pain occur due to poor posture or muscle strains. The most common causes of this pain include:
- Short term injuries: These might occur due to overextending or overusing muscles in the shoulder. Symptoms typically only present in the injured joint.
- Referred pain from other areas of the body: Neck and back pain may trigger aching in the shoulder. Weakness in one muscle might cause the shoulder muscles to overcompensate, leading to pain.
- Injuries in the spine: These might include herniated disks, which put pressure on certain nerves. Some of these nerves lead to the shoulder.
- Osteoarthritis: This is a degenerative condition that progresses over time as the cartilage wears down.
- Rheumatoid arthritis : RA is a long term inflammatory condition that can sometimes affect the shoulder. It occurs when the immune system attacks the joints, causing pain and inflammation.
- Tears in the rotator cuff: This shoulder injury impairs a personâs ability to move, rotate, and lift their arm.
- Frozen shoulder: This term refers to an injury that limits mobility in the shoulder. Underuse, RA, and unusual tissue growth in the shoulder may cause frozen shoulder.
- Poor posture: Slumping over a computer, holding the body in an awkward position for extended periods, and craning the neck can all cause tension and pain in the shoulders. The pain may spread to the neck and back.
Exercise And Physical Therapy
If possible, it can be very helpful to meet with a physical therapist before breast cancer surgery or radiation. There are exercises to do in advance that may reduce the risk of future problems. If it is too late for that, it would still be useful to meet with a physical therapist who can design a personal program to reduce shoulder mobility issues or pain. At BIDMC, we have clinicians who are trained and experienced to work with breast cancer patients with mobility issues. Learn more about BIDMC’s Physical Therapy Services.
Oncologic Physical Therapy
There is a new national certification for physical therapists who have completed training and have experience working with cancer patients and survivors. It is called Board-Certified Clinical Specialist in Oncologic Physical Therapy. If you are seeking a good PT to help with your recovery, ask if s/he has this certification.
Have you experienced shoulder issues after breast cancer surgery? Join the BIDMC Cancer Community and share your story.
Further Studies Reveal Possible Connection
For a later 2010 study, researchers examined the clinical records of 34 patients with malignant shoulder tumors and 505 patients with shoulder pain and stiffness. They found that among the 34 tumor patients, nine had been misdiagnosed initially with frozen shoulder syndrome. Another two also experienced shoulder pain and stiffness before their diagnosis of cancer.
Among the 505 patients with shoulder pain and stiffness, four were later diagnosed as having malignant tumors. One of those four had been initially misdiagnosed with frozen shoulder syndrome.
Altogether, in 10 of the patients, an initial misdiagnosis of frozen shoulder syndrome caused a significant delay in reaching the correct diagnosis and in administering treatment. The researchers suggested that doctors carefully re-examine frozen shoulder patients with imaging tests to check for cancer.
In a more recent 2017 study, researchers noted that frozen shoulder could be a complication or symptom of cancer. They examined data from more than 29,000 patients with frozen shoulder and observed 2,572 cases of cancer.
In this study, researchers identified other types of cancer besides shoulder tumors, including lung cancer, breast cancer, and non-Hodgkins lymphoma, showing that shoulder pain could be a symptom of these cancers as well. The researchers concluded that a frozen shoulder could be an early predictor for a subsequent cancer diagnosis.
Shoulder Pain After Radiation
In March 2019 I had a lumpectomy/sentinel node biopsy right breast and then 4 weeks of radiation. September I couldnt lift my right arm. I went to an acupuncturist, chiropractor, and massage therapist. After none of these worked I went to my pc dr and he referred me to an orthopedic surgeon who said I must have torn my rotator cuff and ordered an mri. I told every specialist and dr about the surgery and radiation and they all said this has nothing to do with that. I was scheduled to have a nerve conduction study when I just happened to have a follow up with my oncology surgeon and he was shocked that none of these drs and specialists knew this has everything to do with radiation! I am now seeing a physical therapist and feeling much better. Whewcancelled the nerve conduction study just in time!
- Post #1
I had breast cancer a little over a year ago. I had 20 treatments of radiation. As I progressed through it I had to have help with my left shoulder to grip the bar. It got progressively worse. About 6 weeks after I went to an orthopedic doctor. MRI showed scare tissue definitely from radiation. My left shoulder was frozen. Surgery wasnt an option. I did therapy, had massages on it & have exercises daily for it. It has finally let go a year later, not completely but much better. Yes, the doctors all agreed it was from the radiation.
- Post #7
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New Lump In Breast Collar Or Underarm
The most well-known warning sign when it comes to breast cancer is a breast lump. A lump can occur in the breast itself, but may also appear in the collar region or underarm. Breast tissue extends from your collarbone to your underarm and rib cage. Lumps are often hard and painless with irregular edges, but some lumps may be painful or tender.
Most breast lumps are not caused by cancer, but if you find a lump, its important to have it looked at by a doctor. It is normal to have breast lumps before your period that go away. If you have a lump that does not disappear at the end of your period, you should alert your doctor.
Breast Cancer Awareness: Shoulder Pain
Breast cancer is the most common cancer among women in the United States . But millions of women are surviving the disease thanks in part to early detection and improvements in treatment.
Shoulder pain in breast cancer survivors is a common condition that should not be ignored. Early detection and treatment are important in preventing long-term complications.
Dr. Eric M. Wisotzsky is the Chief of Rehabilitation Medicine and Director of the Cancer Rehabilitation Program at MedStar National Rehabilitation Health Networks. He is also an Assistant Professor of Rehabilitation at Georgetown University Medical Center.
Many breast cancer survivors who have had surgery, chemotherapy and radiation report shoulder pain especially when lifting their arm overhead. What might be the problem?
Shoulder problems are extremely common after breast cancer treatment. Up to 68% of breast cancer patients may experience shoulder pain and/or restricted shoulder motion. There are two common causes of these symptoms.
What if physical therapy doesnt help?
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Shoulder Pain Becomes Breast Cancer
I’m posting on here as I need some help/guidance/advice as I feel at a loss.
My mum has had shoulder pain over the last few months which she has been to the doctors about numerous times. They sent her for X Ray’s and said that they couldn’t see what was wrong but suspected arthritis. The pain was getting worse and has now spread under her arm so she went back again. The nurse felt her breast and sent her for a mammogram.
On Thursday, my mum was diagnosed with breast cancer that has spread to her lymph nodes. This was the result of a biopsy that she’d had. At the minute we don’t know if it has spread any further or what stage it is. All they have said is that the cells are a grade 3 – which I think means the worst and that they are aggressive?
She’s got to go back on Thursday for some more results related to hormones, but I don’t understand what that means. I’m guessing from this they can start the course of treatment.
However she’s got to wait another 12 days for the CT scan to find out if it has spread.
I’m worried that it has because the pain started in her shoulder – so there is a chance it could be in her bones. Has anyone else ever had that?
I don’t want them to delay the start of the treatment but will that begin after the results of the CT scan which could potentially be a month away or will they start that immediately on Thursday?
Breast Pain Not Linked To Periods
Its often unclear what causes non-cyclical breast pain.
It can be related to:
- a benign breast condition
- previous surgery to the breast
- injury to the breast
- having larger breasts
- a side effect from a drug treatment, such as certain antidepressant drugs and some herbal remedies such as ginseng
Stress and anxiety can also be linked to breast pain.
Non-cyclical breast pain may be continuous or it may come and go. It can affect women before and after the menopause.
The pain can be in one or both breasts and can affect the whole breast or a specific area. It may be a burning, prickling or stabbing pain, or a feeling of tightness.
Non-cyclical breast pain often goes away by itself over time. This happens in about half the women who experience it.
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Coping With Chest Wall Pain
Any type of breast pain can be very distressing, and many women worry they may have breast cancer. However, in most cases pain in the breast isnt a sign of breast cancer.
Having breast pain doesnt increase your risk of breast cancer. However, its still important to be breast aware and go back to your GP if the pain increases or changes, or you notice any other changes in your breasts.
Breast Thickening Or Swelling
Breast thickening or swelling may be a sign of breast cancer. Swelling can also occur around your collarbone or armpits. This may be a sign that breast cancer has spread to your lymph nodes. Sometimes, patients notice breast swelling without ever noticing a lump. Thickening or swelling may cause a noticeable change in the size or shape of your breasts. Thickening or swelling may occur in one breast, or in both.
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What Can You Do About It
One of the first things to remember is that a high percentage of women get this kind of pain. While it may help to do some small amount of range of motion exercises while healing from surgery, never do an exercise after surgery unless your doctor has okayed it. You also dont want to do exercise if you are still in pain from surgery, as that can have a deleterious effect on your healing.
It is not likely, but pain can be a potential sign of cancer spreading. Because cancer can form on the head of the humerus, it can interfere with movement and make it painful. Therefore, your first course of action should be to see your doctor to rule out any spreading of cancerous tumors. Dont get too worried though. The odds of it being cancer are quite low as the development of these tumors generally takes years to develop, has the added symptom of arm weakness, and is becoming quite rare.
Once your doctor confirms that you are not dealing with any cancerous issues in your rotator cuff area, you can concentrate on healing. While time will help, physical therapy, anti-inflammatories, and gentle exercise can certainly be useful in shortening the time it takes to heal from this kind of problem. Before you throw yourself into a PT regime, however, make sure to check with your doctor. He or she will tell you how much you should be using or not using your arm for the best level of healing.