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Suggestions For Alleviating Pain
Robert Wascher, MD, FACS, Ernest Rosenbaum, MD, Alexandra Andrews, Charles M. Dollbaum, MD, PhD, Karen Ritchie, MD, Sarah Schorr, RN, BSN, Francine Manuel, RPT, Jean Chan, BA, MA, SEd, Richard Shapiro, MD

1. Medications: Your healthcare provider may prescribe medications in an effort to reduce or the severity or frequency of your symptoms, including nonsteroidal anti-inflammatory agents (NSAIDs) such as ibuprofen or naproxen, low-dose antidepressants (and SSRI medications in particular), and in rare and severe cases, narcotic pain relievers.

2. Physical Therapy: Early restoration of range of motion in the shoulder and arm is important to prevent a frozen shoulder syndrome, or to treat symptomatic muscle weakness associated with inadvertent injury to the nerves controlling shoulder muscles. These entities can cause pain separate from the neurogenic syndromes that can result from axillary lymph node dissections. Early restoration of upper extremity and shoulder mobility, and use of the arm, will also help reduce the severity of lymphedema.

3. Pain Management Specialists: A referral to a pain management specialist who is certified by The American Board of Anesthesiology-Added Pain Qualification or The American Board of Pain Medicine should be made in patients who do not rapidly respond to the measures already outlined.

4. Supportive Care Approaches may be useful, including guided imagery training, biofeedback, acupuncture, massage therapy, meditation, breathing, exercise (e.g., swimming, stretching), hypnosis, nutritional therapy, topical salves (e.g., calendula, capsaicin, and mentholated creams), placing a small pillow between you and the seatbelt, and wearing loose-fitting clothing constructed from soft, natural fibers.

Remember to proactively consult with your physician or other primary healthcare provider when considering the above interventions!

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