Shoulder Pain and Disability Among Post Mastectomy Patients

Abstract

Purpose The purpose of this study was to determine shoulder pain and disability among post mastectomy patients. Methods This cross sectional study was conducted in Peshawar Pakistan from June 2017 to June 2018. A self administered questionnaire was used to collect demographic information and clinical characteristics while Shoulder Pain and Disability Index (SPADI) was used to evaluate shoulder pain and disability. Female post mastectomy patients with age between 18 to 55 years were included. Patients with co-morbidities, bilateral mastectomy, history of trauma, history of shoulder pain before mastectomy and shoulder pain on non-operated side were excluded. SPSS version 23 was used to analyze the data. Results A total of 127 post mastectomy patients participated in the study. Out of total 127 participants, 99 (77.95%) reported shoulder pain and disability on operated site. Age (P value=0.181) and operated side i. e., right and left mastectomy (P value=0.324) were not significantly associated with shoulder pain and disability. On the other hand marital status (P value=0.04), educational status (P value=0.03) profession (P value<0.001) and time since surgery (P value=0.04) were significantly associated with shoulder pain and disability. Conclusion More than 2 third of post mastectomy patients suffer from shoulder pain and disability. Connective tissue fibrosis of shoulder joint seems to be the only reason for it. Physical therapy after mastectomy can help in preventing shoulder pain and disability.

Effect of early rehabilitation on shoulder pain and disability after modified radical mastectomy

“…Also, A statistically significant difference was found between the study and control groups after application of early rehabilitation ( before discharge as well as 3 months post-operative) with p. value =0.001**. Table (4): It was apparent from this table that the study group had high significant mean practice scores as compared to the control group before discharge and this highly statistically significant difference continued 3 months post-operative. Table (5): stated that, no significant difference was existed between the study and control groups before discharge regarding pain level.…”

Additional intraoperative subpectoral plane block vs conventional pain control: A comparison of shoulder movement in patients with mastectomy

“…Adequate postoperative pain control around the shoulder after mastectomy is necessary to prevent further complications like joint movement restriction, shoulder rigidity, and functional impairment [ 15 , 16 ]. The previous study by Arsh and Ullah found that over 67% of patients who underwent breast cancer surgery experienced shoulder pain and mobility difficulties, which were associated with connective tissue fibrosis in the shoulder joint [ 3 ]. Kim et al further confirmed the presence of adhesive capsulitis, biceps tenosynovitis, and thickening of coracohumeral ligament in post-mastectomy patients with chronic shoulder pain by ultrasonography [ 17 ].…”

“…Second, the pain score obtained in this study was the pain at rest, which might result differently from the pain during motion. However, a self-administered questionnaire of pain section of shoulder pain and disability index (SPADI) in the previous study by Arsh and Ullah demonstrated the similar result of pain score in each activity [ 3 ]. Third, one enrolled patient was not included in the final analysis due to loss to follow-up.…”

“…Extensive resection during surgery could provide nerve damage and inflammatory stimulation, resulting in post-mastectomy pain syndrome (PMPS), which is estimated to affect around 20–50% of patients [ 2 ]. Among patients who underwent mastectomy, shoulder pain is a prevalent issue that restricts shoulder joint mobility and significantly impacts their quality of life [ 3 , 4 ]. Additionally, limited range of motion of the shoulder joint might potentially be a contributing factor in the onset of lymphedema [ 5 ].…”

Effectiveness Of Kaltenborn Mobilization Versus Muscle Energy Technique On Shoulder Range Of Motion In Adhesive Capsulitis

“…It is usually a clinically diagnosed disorder based on history and physical assessment. It is a musculoskeletal condition caused by damage to the soft tissues and joint capsule of the shoulder joint and characterized by inflammation and adhesions (1) . Many etiological and referral factors cause pain in the shoulder such as local pathologies, and abdominal pathologies affecting the viscera, the diaphragm and the liver.…”