Pain after Breast Cancer: Costocondritis
Ask about pain after breast cancer and you often get a vague answer about pain being normal part of recovery and a recommendation to give it more time. That may be true for many women, but not for all. “Not long after finishing radiation therapy, I started getting this pain in my ribs and chest. It is a stabbing and burning pain. The pain only lasts for half a minute when I give it a rub thank goodness!” says one member of the Breast Cancer Network of Australia .
“An ultrasound found the cartilage between my rib bones is lumpy and close to under the skin, which the oncologist says isn’t anything to worry about. It has been there since I had the mastectomy operation early 2009. I asked my surgeon about it and he said it has probably been there forever but now my breast is gone I can feel it. I do worry because it is below the area where my multifocal tumors were situated.” Because she continued to ask, she discovered the source of her pain was actually costrocondrities.
Costocondritis is inflammation of the cartilage that joins the ribs to the breastbone (called costal cartilages). Also known as anterior chest wall pain, costosternal syndrome or parasternal chondrodynia, it causes pain in the chest wall around the breastbone (or sternum) and sometimes is severe.
Costochondritis is a common problem in women who have been affected by breast cancer and acts up in a similar way to arthritis. The pain may be mild to severe with tenderness over the anterior chest and may radiate to the back, shoulders, stomach or arms. Pain is often aggravated with coughing, lifting, straining, sneezing and deep breathing. Pain can be constant or intermittent and can last for several days to multiple months/years.
“Apparently once you get it, it can flare up at any time and you have to be cautious with over-working your arms with things like lifting, painting and sweeping. Sometimes the pain can extend to the shoulder or arm on the involved side.”
When costochondritis is accompanied by swelling of the areas surrounding the cartilage, the condition is called Tietze syndrome which causes localized musculoskeletal pain. In Tietze syndrome, the swollen area of the inflamed cartilage may be tender to the touch, and the skin overlying the cartilage may be reddened.
Physical Therapy for Costochondritis
Often times treatments that improve arthritis symptoms may improve symptoms of costochondritis as well. Treatment options typically include a combination of rest, ice and analgesics, anti-inflammatory medications (Advil, Motrin, Aleve), thoracic mobilization, breathing facilitation techniques and stretches. In some cases of severe pain, cortisone injections or surgery have been utilized- with mixed results. Stretching exercises have shown to be beneficial. Linda Miller from the “Ask the Expert” forum of breastcancer.org states, “I can’t overemphasize the importance of continuing stretching long after you’ve had your breast cancer surgery, especially with mastectomy. The tendency will always be for that skin and pectoral muscle to tighten up, and so stretching 2 to 3 times a week may help relieve some of those long-term chronic symptoms. “
At Therapy Achievements, we specialize in treating pain and mobility limits associated with treatment of cancer. Our therapists have had advanced training in manual therapy techniques designed to reduce pain and swelling and enhance flexibility and movement. We are a Rehabilitation Center that provides Physical, Occupational and Speech Therapy for Balance and Movement, Speech and Swallowing, Swelling from Lymphedema and Edema, Driving Rehabilitation and Functional Living Skills for visual and cognitive re-training. In addition to treating patients with cancer, we help people with Brain Injury, Stroke, Multiple Sclerosis, Parkinson’s Disease, Lymphedema, Vertigo and Dizziness, and other disorders that interfere with mobility and function. We offer VitalStim Technology, Saebo Technology, LSVT LOUD Treatment, LSVT BIG Treatment, and Neuro-Developmental Treatment.