Axillary web syndrome (AWS) is a condition that sometimes occurs after lymph node removal by axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB), for breast cancer diagnosis or treatment. After these procedures, tender cords of tissue can sometimes be felt under the skin. They begin at the armpit and run down the inside of the arm to the elbow, sometimes to the thumb. Tender or sore to touch, they can make arm movements painful and reaching overhead or straightening the elbow can be difficult. AWS (also known as
‘cording’) can appear one to eight weeks after surgery. If you think you may have AWS, Haley Rehab can help.
Causes of Axillary Web Syndrome
More research is needed to understand the exact cause of axillary web syndrome. It is believed that tiny veins and lymphatic vessels are damaged during surgery. This damage can cause inflammation and hardening of the connective tissue.
There may be one distinct rope-like structure or several small cords under the skin. Some people do not feel the cords, but experience pain or a burning sensation along the inside of the arm.
If arm movement is painful, it is common to avoid those positions that cause discomfort. However, this can lead to more problems with mobility and function. It can be particularly problematic if cording occurs at the time of radiation therapy, because the arm usually has to be in a raised position during this treatment.
Treating Axillary Web Syndrome
Early therapy to treat cording can be very effective. With soft tissue mobilization, myofascial release, nerve gliding, scar tissue release and other techniques, therapy can help break down the taut cords, restore movement, improve range of motion and decrease pain. Exercises to stretch the area and education about posture help to decrease the symptoms. Most of the time, cording can be treated within three months.
Our goal is for you to get back to doing the things you love, with the best quality of life possible. If you notice the signs and symptoms of axillary web syndrome, a therapist at Haley Rehab can design a treatment plan that is right for you. Guided stretches and manual therapy can relieve the symptoms, prevent further complications and help you regain shoulder mobility and function.
To learn more about Haley Rehab, or to schedule an initial assessment, call us at 613-422-5061. No referral is required. Contact us today to see how Haley Rehab can help you achieve wellness.