massage for post breast surgery

Conditions: Postmastectomy Lymphedema Syndrome; Pain; Shoulder Mobility Impairment; Breast Surgery

Summary: the aims of this study are to determine the effectiveness of myofascial massage specific to the breast/chest/shoulder area in reducing self-reported pain and increasing mobility among patients who have undergone a mastectomy or other breast surgery compared to a control group receiving global relaxation massages.

post-operative breast surgery patients may face an array of complications. breast surgery can include biopsy, lumpectomy, mastectomy or some type of reconstruction (drackley 2012). chronic pain and lack of mobility in the chest and/or shoulder are two of the more common and persistent issues in this population, however it is still unclear as to how many actually suffer from these (wallace 1996). current treatment for each of these usually includes prescribed narcotic pain medication and/or some physical therapy, the first being a treatment with many side effects, the latter being quite expensive. global and integrated massage techniques have been used as a way of decreasing stress, anxiety, and some self-reported pain, however a targeted massage technique geared towards the breast/chest/shoulder region has not been rigorously evaluated (drackley 2012). myofascial massage has been shown to be an effective treatment for other post-surgical patients in reducing pain and increasing mobility, but efficacy has yet to be shown specifically in post-breast surgery patients (fitzgerald 2009). if proven effective, myofascial massage could be used as an inexpensive and non-invasive addition to current pain and mobility treatment (cassileth 2004). specific aims aim a. determine the effectiveness of myofascial massage specific to the breast/chest/shoulder area in reducing self-reported pain among patients who have undergone a mastectomy or other breast surgery. aim b. determine the effectiveness of myofascial massage specific to the breast/chest/shoulder area in increasing self-reported mobility in the affected shoulder among patients who have undergone a mastectomy or other breast surgery. hypothesis: compared to control patients receiving general full body massage, myofascial massage specific to the breast/chest/shoulder area reduces pain and increases mobility in patients who have undergone breast surgery.

Eligibility criteria:
inclusion criteria: * age range 21-79 years of age * female * breast and/or axillary surgery * 2-18 months post-operative * meets minimum pain and/or lack of mobility threshold as determined by survey * ability to give informed consent * ability to complete adherence task * benign or malignant forms of disease exclusion criteria: * history of blood clots * mentally incompetent * non-english speaking * infected sites or open wounds * currently lactating * currently receiving massage therapy for breast surgery * currently taking anticoagulants including: cilostazol clopidogrel ticlopidine prasugrel ticagrelor dipyridamole warfarin dabigatran rivaroxaban apixaban abciximab eptifibatide tirofiban dalteparin enoxaparin fondaparinux heparin tinzaparin argatroban bivalirudin lepirudin

Keywords: post breast surgery myofascial massage pain mobility limitations