Postmastectomy pain syndrome (PMPS) is a chronic pain condition often experienced by patients after undergoing a mastectomy, the surgical removal of one or both breasts, typically to treat or prevent breast cancer. Defined by the persistence of postoperative pain in the chest, armpit, or arm, PMPS can last well beyond the typical recovery period expected after surgery. PMPS is characterized by symptoms that may include sharp, burning, or aching sensations in the aforementioned areas, impacting daily activities and overall quality of life.

Patients anticipate certain common experiences during recovery from a mastectomy, which may include discomfort, tissue firmness, swelling, or a wound that drains fluid. However, when pain endures beyond the normal healing time — typically marked by a decrease in these symptoms — it may be indicative of PMPS. It’s important to note that PMPS is not exclusive to those who have had mastectomies; it can also affect those who undergo breast-conserving surgeries, such as lumpectomies.

Why is it important to understand PMPS?
Understanding PMPS is crucial as it can significantly impact quality of life after breast cancer surgery. Since the pain associated with this syndrome can persist for months or even years, it’s essential for both patients and healthcare providers to recognize the signs early on. Timely diagnosis can lead to effective treatment strategies, potentially preventing further complications such as restricted arm movement and mental health issues.
Who is the most affected by PMPS?
PMPS is a challenging condition affecting a significant number of individuals after breast surgery, with studies indicating that about 20 to 30 percent of those who undergo a mastectomy are likely to develop PMPS. Especially noteworthy is the higher incidence observed in younger women under the age of 40. Ethnicity appears to be a factor as well, with African American and Hispanic women reporting higher rates of the syndrome than their counterparts.

The development of PMPS also seems to be influenced by specific surgical procedures, particularly those that involve extensive tissue removal from the breast and underarm regions. Understanding these risk factors is key to providing targeted and effective treatment for those experiencing PMPS.

Common symptoms of PMPS
PMPS is characterized by nerve-specific pain, which can manifest as shooting, stabbing, prickling pain, tingling, itchiness, or numbness. These symptoms can make it challenging for healthcare providers to distinguish neuropathic pain, which is pain caused by damaged or dysfunctional nerves, from other types of pain. Therefore, it’s beneficial for patients to document their symptoms as they experience them, providing as much detail as possible about the nature of the pain, its frequency, and timing. Common symptoms of PMPS may include pain and tingling in the chest wall, armpit, arm, and shoulder, pain in the surgical scar, numbness, shooting or pricking pain, and intense itching.
How symptoms vary across different Individuals
The symptoms of PMPS can vary widely among different individuals. Factors such as the patient’s overall health status, the type and extent of surgery they’ve undergone, and their individual pain tolerance can all influence the nature and severity of PMPS symptoms. Some patients might experience mild discomfort that only slightly interferes with their daily activities, while others might suffer from severe, debilitating pain that significantly hampers their quality of life. Furthermore, the location and type of pain can also vary, with some patients experiencing more localized pain in the chest or armpit, while others might have more widespread pain affecting the entire arm or shoulder.
Long-term effects of PMPS symptoms

If you’re recovering from a mastectomy or lumpectomy, staying vigilant about your symptoms is essential. Contact your healthcare provider without delay if you experience:

  • Persistent pain in the chest, armpit, or arm that lasts for several months post-surgery
  • Worsening pain or pain that becomes more frequent, which could indicate Post-Mastectomy Pain Syndrome (PMPS)
  • Ongoing numbness, tingling, or itching that doesn’t improve with time
  • Notable changes in your arm or shoulder mobility that may affect your daily activities

Beyond these symptoms, maintaining a schedule of regular check-ups post-surgery is crucial. These appointments allow your healthcare provider to track your healing journey, make timely interventions if needed, and provide peace of mind as you recover.

Overview of PMPS causes
The exact cause of PMPS is not clearly defined, but the most common theory suggests that it might occur when a nerve or nerves become damaged during surgery. PMPS is considered a neuropathic disorder, which means it’s associated with damage or dysfunction of the nerves. While it’s common to experience pain and discomfort during the recovery process after a mastectomy or lumpectomy, prolonged pain might be indicative of more than just a lengthy healing process. It could signal a condition like PMPS, where the nerves are affected, causing persistent pain. Inflammation following the surgery can also play a role in the development of PMPS.
Common factors contributing to PMPS
Several factors can contribute to the development of PMPS. These include the type of surgery performed, particularly if the surgery involved removing tissue from the upper outside portion of the breast or the underarm area. Procedures that involve the removal of a significant number of lymph nodes to check for cancer have also been associated with a higher risk of PMPS. Furthermore, treatments such as radiation therapy following surgery can increase the risk of PMPS. Mental health conditions like anxiety or depression prior to surgery have also been linked to a higher likelihood of persistent post-surgery pain. Genetic factors and the patient’s overall health status can also influence the risk of developing PMPS.
Treatment options for PMPS

Physical therapy
Physical therapy stands as a crucial intervention for patients grappling with post-mastectomy pain syndrome (PMPS). Recognizing PMPS as a neuropathic condition, it’s essential to address musculoskeletal dysfunctions and pain that often compound the chronic nature of PMPS. Through carefully tailored physical therapy programs that incorporate strengthening exercises and therapeutic massage, patients can experience an alleviation of shoulder pain. Furthermore, physical therapy serves to augment range of motion and flexibility, diminish stiffness, and fortify the muscles around the cervical spine, scapula, and the overall shoulder girdle.

Myofascial release therapy
Myofascial release (MFR) therapy is recognized for its effectiveness in managing PMPS. Certified MFR therapists specialize in treating the myofascial tissue which is the continuous, strong, fibrous web of connective tissue that encases and supports all structures in the body. Its benefits are multifaceted, addressing not only the symptomatic pain but also the underlying contributors to discomfort, such as scar tissue tightness, myofascial restrictions, and sustained nerve compression.

In practice, MFR therapy carefully brings gentle, sustained pressure to areas of tension and restriction within the myofascial tissue. This strategic intervention sets in motion a cascade of physiological responses. It encourages vasodilation, boosts localized circulation, and stimulates the stretch reflex of the myofascial complex. As a result, MFR has been known to alleviate the deeply entrenched pain characteristic of PMPS, enhance range of motion, and facilitate a smoother recovery post-mastectomy.

By accessing MFR Health, patients have access to a network of professionals, trained meticulously in the John F. Barnes’ methodology of MFR therapy. This method is not a mere symptomatic remedy; it aims at achieving long-term wellness and pain resolution for PMPS patients, aiding them in reclaiming an active, pain-free lifestyle.

Alternative treatments
While traditional physical therapy and MFR therapy are cornerstone treatments for PMPS, incorporating alternative treatments can complement these methods. Treatments such as acupuncture, yoga, and therapeutic massage may be integrated into a patient’s regimen to enhance pain management outcomes. These practices not only aim to reduce pain but also to increase mobility and provide stress relief, which can be particularly beneficial for PMPS sufferers.

Lifestyle changes play a critical role as well. Patients who adopt a healthy diet, engage in regular physical activity, and employ stress management techniques often report a reduction in their symptoms. Current research on the efficacy of these alternative treatments for nerve-related pain, like PMPS, is promising, though ongoing. Studies suggest that these integrative approaches may reduce the need for medications and improve the overall quality of life.

Diving deeper into MFR therapy
As mentioned above, MFR therapy focuses on releasing tension in the myofascial tissue. The myofascial tissue is a sheet of connective tissue that extends throughout the body to provide support and protection to our muscles, bones, and cells. Over time, this tissue can become tight or restricted due to injury, inflammation, or stress, which can lead to pain and restricted movement.

MFR therapy involves applying gentle, sustained pressure and stretch to the myofascial connective tissue to alleviate these restrictions. The John F. Barnes’ methodology of MFR therapy is particularly effective because it recognizes the complex interconnections of the myofascial network and treats the body as a whole. Instead of isolated treatment of individual muscles or body parts, this method aims to address the broader myofascial system to catalyze holistic healing and recovery.

Through a series of treatment sessions with our skilled therapists, individuals experiencing discomfort may find significant relief, improved range of motion, and a return to their favorite activities. The process of MFR therapy is tailored to each person’s unique body and specific challenges, ensuring a personalized approach to wellness and healing.

How MFR therapy helps PMPS
MFR therapy can be highly beneficial for patients with PMPS. By targeting the root cause of the pain, which is often related to nerve damage or tension in the myofascial tissue, MFR therapy can help alleviate the persistent pain associated with this syndrome. Moreover, MFR therapy can also help improve range of motion and flexibility, which can be significantly affected by PMPS. By alleviating pain and improving physical functionality, MFR therapy can greatly enhance the quality of life for PMPS patients.
Finding the right MFR therapist for PMPS treatment

Finding the right MFR therapist for PMPS treatment is crucial to achieving optimal outcomes. It’s important to choose a therapist who is trained and certified in the methodology developed by John F. Barnes, the leading practitioner in the field of MFR. The therapist should also have experience in treating patients with similar conditions, and they should be able to tailor the therapy to your specific needs and symptoms. At MFR Health, we make connecting with a certified MFR therapist near you easy. Our platform is designed for ease of use, offering a free search capability to help you find the right therapist for your PMPS treatment.

Managing PMPS in everyday life

While living with PMPS can be challenging, it’s important to remember that with the right treatment and support, it is possible to manage the condition effectively and enjoy a high quality of life. Ongoing research into the causes and treatment of PMPS continues to bring new hope and possibilities for those affected by this condition. Whether you’re just starting your journey with PMPS or you’ve been managing the condition for some time, we’re here to help you every step of the way. Find a certified MFR therapist today and start your journey towards relief and recovery.