Shoulder Pain After Breast Surgery

Why Does Shoulder Pain Occur After Breast Surgery?

Postoperative shoulder pain is associated with various factors, which may vary depending on the type of surgery and the body’s individual response. The main causes include:

1. Restricted Movement and Stiffness

After breast surgery, many women avoid moving their arm due to fear of pain or injury to the operated area. Immobilisation can lead to stiffness and loss of range of motion in the shoulder joint.

2. Problems with Lymphatic Flow (Lymphoedema)

If lymph nodes have been removed from the armpit, lymph may not circulate properly, causing swelling and heaviness in the upper limb. This condition can affect shoulder movement and cause discomfort.

3. Neuropathic Pain

During surgery, small nerves around the breast area may be damaged, causing neuropathic pain, numbness or a burning sensation that extends towards the shoulder and upper limb.

4. Rotator Cuff Inflammation

Prolonged immobilisation or changes in posture due to the surgery may lead to inflammation of the rotator cuff tendons of the shoulder, causing pain and weakness during movement.

5. Frozen Shoulder (Frozen Shoulder)

This syndrome occurs when the shoulder joint becomes increasingly stiff, restricting mobility. It is quite common in women who avoid moving their arm after surgery, as well as following radiotherapy.

How to Manage Shoulder Pain After Breast Surgery

By following appropriate treatment approaches, women can obtain relief from pain and restore normal shoulder mobility.

1. Gentle Mobilisation and Stretching

Early and gradual mobilisation of the shoulder is essential. A physiotherapist can recommend specific stretches to restore joint flexibility, such as:

• Slowly raise your arm in front of you to shoulder height and hold it there for a few seconds.
• Perform circular movements with the shoulder to maintain joint function.
• Place your fingers against the wall and try to gradually “walk” your hand upwards.

2. Physiotherapy and Therapeutic Exercise

Professional guidance from a physiotherapist can help restore shoulder mobility correctly, reducing pain and tension.

3. Management of Lymphoedema

• If there is swelling in the arm or shoulder, the use of compression bandages and specialised exercises may help improve lymphatic flow, always under the advice and guidance of the breast surgeon.
• Avoid wearing tight clothing or jewellery that puts pressure on the area.

4. Medication for Pain Relief

The treating doctor may recommend painkillers or anti-inflammatory medication to manage the pain. If neuropathic pain is present, specific medications targeting the nervous system may be prescribed.

5. Application of Warm or Cold Compresses

• Cold compresses can reduce inflammation and swelling.
• Warm compresses improve blood circulation and relax the muscles around the shoulder.

6. Improving Posture

After breast surgery, many women tend to adopt poor posture due to fear of pain. Correct posture, keeping the shoulders in a neutral position and avoiding slouching can reduce strain on the shoulder.

When to Visit an Orthopaedic Surgeon

If shoulder pain remains severe or limits your daily activities, it is important to consult a specialised orthopaedic surgeon. Mr Andreas Leonidou, with many years of experience in shoulder conditions, can recommend personalised solutions, such as:

• Specialised examinations (ultrasound, X-rays, magnetic resonance imaging) to identify possible problems.
• Targeted physiotherapy interventions to improve mobility.
• Injectable treatments (cortisone, PRP) if persistent inflammation is present.
• Surgical procedures in more severe cases, such as frozen shoulder.

Read also: Shoulder Calcification: Symptoms & Treatment, How Shoulder Tendinitis Affects Athletes: Rehabilitation and Return to Sports and Return to Sports Faster After an Injury. More answers in the frequently asked questions.