Exercise Helps Ease Arm, Shoulder Pain After Breast Cancer Surgery

November 12, 2021
Ernie Mundell and Robert Preidt

Arm and shoulder pain are common for women after breast cancer surgery, and beginning a supervised exercise program soon afterwards can go a long way to easing the discomfort, new research suggests.

As the team of British investigators explained, restricted shoulder movement and chronic pain or swelling in the armpit area can really impact a patient's recovery and quality of life.

However, "we found robust evidence that early, structured, progressive exercise is safe and clinically effective for women at higher risk of developing shoulder and upper limb problems after non-reconstructive breast surgery," said the team led by Julie Bruce. She's a professor in the Warwick Clinical Trials Unit at the University of Warwick, in England.

In the new study, Bruce's group tracked outcomes for almost 400 British women, average age 58, who underwent non-reconstructive breast cancer surgery.

Half of them received usual care -- simply being handed information pamphlets -- while the other half received usual care along with a structured exercise program that was led by physiotherapists. The exercises included stretching, strengthening, physical activity and behavioral changes.

The program began seven to 10 days after surgery, with two additional appointments one and three months later, the researchers said.

One year after surgery, the women in the exercise group said they had lower pain intensity, less arm disability and better health-related quality of life than those in the usual care group.

There were no differences in nerve pain, wound-related complications, surgical site infections, swelling or other complications, according to the study published online Nov. 11 in the BMJ.

One expert in the United States wasn't surprised by the findings.

"Exercise is a valid rehabilitative measure, as well as a safe and effective tool to empower cancer patients to thrive in their recovery," said Dr. Paul Baron, chief of breast surgery at Lenox Hill Hospital in New York City.

The exercise program was also cost-effective, the researchers noted in a journal news release. The exercise regimen ended up costing an average of $173 (US dollars) per patient, but that was more than offset by an average savings of $518 (US dollars) per patient in the exercise group when the researchers considered all health care and personal social service costs.

Bruce's team also suggested that their exercise program "is suitable for wider implementation in clinical practice."

More information

Breastcancer.org has more on recovering from breast cancer surgery.

SOURCES: Paul L. Baron, MD, chief of breast surgery, Lenox Hill Hospital, New York City; BMJ, news release, Nov. 11, 2021

Cancer: Breast Exercise: Misc.Inflammation Pain Physical Therapy Surgery: Misc.Therapy &, Procedures: Misc.