Effect of Extracorporeal Shock Wave Therapy on Intercostobrachial Neuralgia Post Mastectomy
PURPOSE: The main objective of the study is: to evaluate the therapeutic effect of ESWT on intercostobrachial neuralgia post-mastectomy. BACKGROUND: Intercostobrachial neuralgia post-mastectomy is thought to develop from surgical damage to the intercostobrachial nerve, this nerve is injured in 80-100 % of mastectomy patients who undergo axillary lymph nodes dissection. Pain that is localized in the axilla, medial upper arm, breast, and/or chest wall significantly affects the patient's mood, everyday activities, and social functioning, causing a heavy economic burden on healthcare systems. If poorly treated, patients may develop an immobilized arm, which can lead to severe lymphedema, frozen shoulder syndrome, and complex regional pain syndrome. HYPOTHESES: It will be hypothesized that: Shock wave therapy has no effect in improving intercostobrachial neuralgia post-mastectomy.
• Age range will be from 40 to 65 years.
• All patients will be female patients suffering from intercostobrachial neuralgia after unilateral modified radical mastectomy.
• All patients suffering from moderate or severe pain of burning, tingling, numbness, and electric nature persisting for 3-5 months following mastectomy, in the anterior chest wall, axilla, upper medial arm with altered sensitivity of the skin in the painful area.
• All patients had unilateral mild to moderate lymphedema (circumference difference 4 cm).
• All patients will have completed their chemotherapy or radiotherapy treatment.
• All patients enrolled to the study will have their informed consent.