Mastalgia Due to Degenerative Changes of the Spine

Abstract

people, and the prevalence increases in the fifth decade of life. Cervical radiculopathy is the result of cervical nerve root pathology, often caused by space-occupying lesions such as cervical disc herniation, spondylosis, or osteophytosis. These space-occupying lesions produce upper extremity radicular symptoms such as pain, numbness, weakness and paresthesia. The C6 and C7 nerve roots are most commonly involved in cervical radiculopathy [3].The aim of the present study was to define the incidence of vertebral pathologies in patients with non-cyclic mastalgia and the efficacy of conservative treatment of these pathologies on relieving breast pain. Mastalgia, which is the reason for 50% of all referrals to breast clinics, affects up to 75% of women during their lives. It is a common and enigmatic condition, the cause and optimal treatment of which are still inadequately defined. It may be severe enough to affect the patient's usual daily activities, and its effect on quality of life is often underestimated. Evaluations of breast pain vary depending on whether it is classified as cyclic mastalgia, noncyclic mastalgia or extramammary pain. This distinction is important because the evaluation and the response to interventions vary among the different types of breast pain [1,2].Cervical radiculopathy is frequently encountered, with an annual incidence of 83. AbstractBackground. Mastalgia is a common and enigmatic condition; the cause and optimal treatment are still inadequately defined. Cervical radiculopathy, which is the result of cervical nerve root pathology often caused by spaceoccupying lesions such as cervical disc herniation, spondylosis, or osteophytosis, is frequently encountered in physical therapy. Objectives. The aim of the study was to evaluate the incidence of vertebral pathologies in patients with non-cyclic mastalgia and the efficacy of conservative treatment of these pathologies on relieving breast pain. Material and Methods. One hundred patients were included in the study, all with breast pain continuing throughout the day and lasting at least three months. Breast and axillary physical examinations, mammographic and/or ultrasonographic evaluations were normal in all the patients. The patients' pain levels were scored using a visual analog scale (VAS). Cervical and thoracic spine magnetic resonance imaging (MRI) was performed on all the participants. Results. Among 96 patients that had pathological findings on magnetic resonance imaging (96%), 49 women had diffuse annular bulging of the cervical spine, and 47 had cervical disc protrusion. Additionally, 12 patients had thoracic disc protrusion. At the end of the three-month period, the patients who were given only conservative treatment returned for follow-up evaluations. According to the VAS scores, five patients had mild to moderate improvement, 55 showed significant improvement, and 29 achieved complete remission. Conclusions. The authors concluded that if none of the known causes of breast pain are found in a patient, the patient should be eva...

The Efficacy of Physical Therapy to Alleviate Symptomatic Thoracic Radiculopathy: A Systematic Review and Meta-Narrative Analysis

“…None were randomized controlled trials (RCTs) and five were case studies [ 11 , 12 , 14 - 16 ]. The remaining two were a prospective cohort study and a retrospective cohort study [ 3 , 13 ]. Patient characteristics are described below in the meta-narrative of included studies.…”

“…The overall study quality assessment demonstrated three studies had “good” quality [ 12 , 14 , 16 ], one had “fair” quality [ 11 ], and three had “poor” quality of evidence [ 3 , 13 , 15 ] using the NHLBI Study Quality Assessment Tool for Observational Studies ( Figs. 2 - 4 ) [ 8 , 9 , 17 ].…”

“…Pirti et al [ 13 ] conducted a prospective cohort study of 139 patients with non-cyclic breast pain. One hundred had normal breast and axillary examinations, negative mammography and/or negative ultrasounds.…”

“…The overall study quality assessment demonstrated three studies had "good" quality [12,14,16], one had "fair" quality [11], and three had "poor" quality of evidence [3,13,15]…”

ACR Appropriateness Criteria® Breast Pain

“…This type of pain is not associated with malignancy [8]. Benign causes of breast pain are numerous and include hormonal variations, larger cup size, ill-fitting or unsupportive bra, lower levels of fitness or activity, fibromyalgia, cysts, periductal mastitis, stretching of Cooper ligaments, fat necrosis, surgery, Mondor disease, diabetic mastopathy, duct ectasia, musculoskeletal disease, referred nerve root pain from degenerative spinal changes, herpes zoster, heart disease, biliary pain, and peptic ulcer [3,5,[16][17][18][19][20][21][22][23][24][25][26].…”