Expert: Claes-Gustaf Nordquist, M.D. - 1/31/2007

Question
I am guarding in my shoulder, experiencing frozen shoulder and underarm and back of arm pain, but no swelling at all, where I've had 20 lymph nodes removed.  The surgery was about 3 weeks ago.  Should I still have pain there?  If there's no swelling, what's causing the pain?

When could I start physical therapy to help relieve that pain?

They weren't cancerous, so they won't be radiated, but the rest of my breast will, by the wya.


Answer
Yes if a lumpectomy was performed as I assume it was you should have radiation therapy to the rest of your operated breast. Madame, surgery where 20 lymph nodes have been taken out from your armpit area is quite an extensive surgery. I'm not at all surprised that you still have a lot of pain there. You automatically get a muscle spasm there due to your pain that makes movement of the shoulder difficult (it is the way your body protects your injured shoulder area). However that spasm can increase the pain just through the spasm itself and even cause a real "frozen shoulder" to develop. Be grateful there is no swelling. If a swelling develops it may due to the injured lymph drainage from your arm after this your lymph node surgery develop into a "lymph edema" a more or less chronic swelling which is almost - at least - impossible to treat. So be careful with that arm! Yes you should train your mobility with it, but do NOT overburden it! Good luck!