There are a number of reasons for pain or discomfort to extend down into the arm after having breast cancer surgery or radiotherapy. Each of these reasons may benefit from a slightly different approach, and any rehab treatment should involve low stretch or low tension.
Because we all have to decide what initial action to take for our health and wellbeing, I've got three tips for you:
TIP 1: If you have early experiences of down the arm symptoms, have medical checks first.
For everyone who’s had a cancer diagnosis; you don’t want to risk missing it a second time around. So it is really very reasonable to have unusual experiences checked out.
If you receive the great news that there are no (cancer) abnormalities detected, then you can feel confident in pursuing alternate or conservative options - Tips 2 & 3.
Tip 2: Know that there are many other reasons for pain and discomfort extending into the arm
Reason 1: Referred pain from the muscles at the back or front of the upper torso.
Because of the amazing study into trigger points, by Dr Janet Travel and Simons, we know that the back shoulder muscles, when they are tight, can refer pain or even funny feelings into the back of the arm, or as far down as the wrist. Whereas tight front chest muscles can send pain sensations to the front of the upper arm, into the inside elbow and potentially can extend to the wrist.
You can check out the referral zones or even purchase a low-cost poster by searching:
TRIGGER POINTS 1 &2 ANATOMICAL DIAGRAM GUIDE CHART ANATOMY PRINT PREMIUM POSTER
I also have a self-treatment approach for pain referred from tight muscles. I talk more about this in the past blog where I show you my back shoulder Treatment Buddy.
Reason 2: The arteries to the arm can be tensioned and even compressed
Image: Arteries and nerves that come under the collar bone to the arm: Mikael Häggström, used with permission. - Image:Gray523.png, Public Domain, https://commons.wikimedia.org/
This reason is just new to me, as I’ve recently deep-dived into anatomy dissection studies. My professional learning, like most health professionals, involved textbooks and online images where each muscle, nerve and artery is carefully drawn into their anatomical location.
But the recent dissection studies have shown that these structures are sooooo connected by interconnected tissues- just like any piece of fruit you might open up or any piece of meat you might need to cut into.
The arteries at the chest that then run down into the arm are directly connected at the other end to the heart and to the head.
What I didn’t fully realise is that the artery system can tension up because of:
· some of the chemo drugs
· radiotherapy
· local compression by tight muscles at many locations ( pectoralis minor especially, it's the one cut in the image above and is affected during surgery and radiotherapy)
Kiera Schumaker has been my inspiration for this new learning in artery tension. She's developed and now teaching other health professionals to use low tension methods to reduce strain in the arteries and check for associated gains in local movement at the head and arms.
Kiera has a low cost 2-hour online training that will suit health professionals or people who have their own down the arm pain. Or I because of my training with Kiera, I can now offer treatment strategies in face-to-face services or online consult.
Reason 3: The local nerves at the shoulder can be tensioned or compressed.
The nerves exit the spine at the neck and upper thoracic spine. In most instances, the larger nerves run so near to the arteries that they look like a protective structure to the larger arteries. Which when you think about the grand design of things- protecting large blood vessels is a worthy cause for health and survival.
But again the nerves are at risk of getting compressed, as then compromised, as they pass between or through muscles at the neck and especially under the collar bone. If people end up with tightness in their tissues following surgery, there is an additional risk that the local smaller nerves can be compressed.
Nerve pain that refers down the arm can have feelings of aching, pain or tingling, pins and needles or temporary (hopefully) loss of sensation and possibly weakness if the motor nerve is compressed.
I really enjoyed my training with Emrys Goldsworthy (Brisbane); we spent time investigating where the local nerves in the neck, shoulder and arm travelled, what they felt like if they were unduly tensioned and how to make immediate changes in strength by gaining some more elasticity in tensioned nerves.
Treatment is available for nerves that have temporary and intermittent compression.
Tip 3: Find a therapist who is trained in oncology, preferably in this instance breast cancer.
Therapists with oncology training will have a variety of low tension and low stretch methods for managing problems within the tissues as listed in the reasons above. But you will appreciate that health professionals are all on a learning curve and so not all therapists will have skills in all three areas listed in the reasons for pain or discomfort.
So talk with your local oncology trained therapist and see what skills they have to manage potential reasons for down the arm pain or discomfort; remember www.foundation96.com will have a postcode listing to help you locate a therapist nearby.
If you haven’t got access to a trained oncology therapist in your town, then I can assure you that online consults can also be beneficial. There are a number of ways that you can be guided in online sessions to test for the three reasons for down the arm pain or discomfort AND then self-treat.
Connect with Denise Stewart by email at the connect button top right of this page to take action on down the arm pain or discomfort if you are in Brisbane or you would like to arrange an online consult