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Shoulder Pain and Dysfunction After Radiation

longtermsurvivor's picture
longtermsurvivor
Posts: 1755
Joined: Mar 2010

Remembering that I have had radiation twice, most will not run into this problem.  But some will, and as I've not seen a reference to it before, thought I'd talk about this situaton.  It has taken me awhile to figure out I had a problem.  

Beginning soon after my last radiation, I started having mild bilateral shoulder pain.  I had deconditioned a lot during treatment, and I assumed it would get better with time.  I started an exercise program,  including jogging and wieghtlifting immediately upon completion of radiation, and my stamina got rapidly better.  But not my shoulder pain. I I noticed that, although I made progress on the weights, I have only regained about 70% of my previous capabilities.  My pain is pretty non-specific.  Central to both shoulders, not in a spot which suggests  a trigger point, therefore not in my mind suggestive of a specific diagnosis.

Six months ago my Tai Chi instructor told me I had bad posture, and that I needed to work on it.  I thought "what?" I've never had bad posture before.     None of this has been at a level I've even mentioned it to my ENT oncologist.  Anyway, yesterday I got to palpating my posterios shoulder, at least to the best of my ability.  And I found that I have signifcant loss of the mid portion and upper portion of both trapezius muscles.  This led to a websearch for shoulder problems related to radiation. 

It didn't take long for a websearch to discover the situation.  So I'm posting the definitive article on the topic of radiation fibrosis and its effect on shoulder musculature.  I'm going to immediatly modify my exercises to include strengthening of the affected muscles (trapezius exercises are straightforward, but heretofore not included in my program).  I will resume my stretching exercises for the areas of difficulty, and have recruited help from my family on maintaining currect posture.  I  will also arrange to see the radiation oncologist for additional  discussion.

The posture component of this is pretty subtle.  My posterior muscles have weakened, but the anterior muscles (like pectoralis) have not weakened.  So a stooped shape now feels normal.  Pretty sneaky.  Anyway, here's the reference:

 

http://now.aapmr.org/PMRJournals/201111_1041_RadiationFibrosisSyndromeNeuronmuscular.pdf

 

Hoping this is of some use to others.

 

Pat

 

 

 

 

 

 

 

KTeacher
Posts: 874
Joined: Jan 2011

You google well!  I looked at the article quickly, will need to download on paper, I'm old fashioned!  Yesterday my husband asked how my back was, he noticed that one shoulder is lower than the other as I walked up to a counter.  My neck problems I have associated with dissection but haven't been able to figure out my cheek and chin.  I think that this article has to do with me also.  Maybe Skiffin could put this into the Superthread.

Thank you for your continued support on this site, I appreciate your input.

Bev

longtermsurvivor's picture
longtermsurvivor
Posts: 1755
Joined: Mar 2010

If you google around this topic, like "fibrosis" + "trapezius" + "therapy" and other permutations of the key words, you will find that Sloan Kettering seems to have the most input into the literature. They have some stuff on treatment of shoulder drop  after spinal accessory nerve damage from radical neck disection that involves physical therapy and electrical stimulation, seemingly with pretty good results.  I had thought this situation to be permanent,  but maybe not so.

 

Pat

KTeacher
Posts: 874
Joined: Jan 2011

again.  I wasn't sure what words to type in, will try.  I find that I need to go to appointments educated.  My doctor at Stanford is the only one that seems to get things done.  I will be looking for a new rad, or mabe not, my doctor has moved on (I don't blame him in this town!).

D Lewis's picture
D Lewis
Posts: 1518
Joined: Jan 2010

Thank you, Pat.  This shoulder issue is an on-going problem with me.  You've (once again) given me the information i need to go forward with.  I LOVE this site, and I am so grateful to you for your continued input.

Deb

fishmanpa's picture
fishmanpa
Posts: 1098
Joined: Jan 2013

Thanks for posting Pat.

I have shoulder issues due to my surgery but the rads had to do more damage from what I just read and I won't really know for some time what the long term effects will be. Just started getting a funky electric shock feeling on the left side that goes from my neck down into my shoulder blade area when I move my head a certain way...  

Rads really do keep on giving don't they?

Positive thoughts and prayers...

"T"

katenorwood
Posts: 1800
Joined: May 2012

Great information as always.  I'm back into a form of yoga for my breathing and mind and body issues.  You have been an inspiration to me for the past few months....as there have been days I just want to crawl into a hole and say I quit.  Thanks again Pat !  Hugs sent !  Katie

ET@cowboy
Posts: 15
Joined: May 2013

Howdy Long term survivor, I do not post a lot however, I have a few questions. When you started jogging after rad tx how did that go? What are some tips for dealing with no saliva when running? How long did it take to get your stanima back? I am only 32 days out of rad treatment and 3 months from neck disection and robotic surgery. I know i have a ways to go and it is still early. I am frustrated though. I am thakful for what I have and happy to be alive. I can walk about 1.8 miles. I guess I'll never be a as good as I once was but I'd like to be close. I live in a hot and humid climate and it is summer. Any tips would be helpful.

longtermsurvivor's picture
longtermsurvivor
Posts: 1755
Joined: Mar 2010

I've learned a few tricks, having had to rehabilitate several times now.  Let me PM you.

 

Pat

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