49 year old lady, with history of breast cancer, presented with significant chest wall pain post mastectomy. Pain had been persisted for more than 6 months. She described significant sensitivity and burning sensation over the chest wall, with radiation to the axilla. She also complained of sensitive over the upper part of the arm. in the area. The pain was exacerbated by light touch and on contact with her clothes. She found it difficult to tolerate a bra. The pain limited her activities significantly and disturbed her sleep.
PREVIOUS INVESTIGATIONS/ TREATMENTS
The patient had seen various specialists in the past including physiotherapists, osteopaths, and the breast team. She was investigated with an ultrasound scan and an MRI scan which did not show any recurrence of her cancer.
The patient was taking a cocktail of medications including Amitriptyline, Pregabalin, Co-codamols, and Paracetamol without benefit.
TREATMENT FROM DR. KRISHNA AT PAIN SPA
The patient saw Dr. Krishna at his private clinic in Bristol, desperate for some pain relief. Dr. Krishna diagnosed her of post mastectomy pain syndrome and offered her trigger point injections under ultrasound guidance. Dr. Krishna targeted the pectoral muscles and the serratus anterior muscle with local anaesthetic and steroid.
The patient responded very well to the injection treatment, with 60-70% reduction in pain within 2 weeks. She came back for further treatment and Dr. Krishna offered her trigger point injections with botox, which significantly reduced the pain and the sensitivity.
At the follow-up appointment 6 months after the injection treatment, the patient reported almost complete pain relief. She has managed to reduce her medications significantly and was back to work. She was much more functional and her sleep had improved significantly as well.
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