Breast cancer surgery is not an easy thing to go through. It is a time of great struggle, both physically and mentally. So during the recovery period after this surgery, you may sometimes have to face new, unimaginable discomfort. When you raise or straighten your arm, do you suddenly feel a pain like something like a string pulling under the skin from your armpit down the arm? If so, you may also have this condition called 'cording' that we are going to talk about. Don't worry, this is not something that many people know about. So let's talk about it clearly and simply.
What exactly is 'Cording'?
Simply put, 'cording' is a condition that can occur a few weeks after breast cancer surgery. This is when you develop a tight, rope-like or string-like mass under your skin, from your armpit down your arm, sometimes past your elbow. This can be a single string, or it can be a collection of strings. The medical term for this condition is 'Axillary Web Syndrome'.
These 'cords' or tight threads make it very painful to try to fully extend or lift the arm. It feels like someone is grabbing a vein in the arm from the inside and pulling it.
This condition occurs after surgery for breast cancer, especially surgery to remove the lymph nodes in the armpit. This means that it can occur after either a mastectomy (surgery to remove the entire breast) or a lumpectomy (surgery to remove only the cancerous lump). However, it does not occur in everyone. About one in ten women who have breast cancer surgery may develop this condition. However, if this condition occurs, it is essential to seek treatment because it can greatly interfere with arm movement.
What are the characteristics of this 'coding' condition?
It's not that difficult to tell if you have this condition. The main symptoms are clearly visible. Let's take a look at what these symptoms are and how they make you feel.
| Symptom | How you feel and look |
|---|---|
| Stiff, thread-like tissue | A string or rope-like object running from the armpit down the arm, under the skin, can sometimes be seen with the naked eye if the arm is slightly extended. |
| Pain and stretching | When you raise your arm, straighten it, or pull it to the side, you feel a sharp pain and a pulling sensation in the armpit and elbow area. |
| Restriction of movement | This pain and stiffness makes it impossible to fully raise the arm above shoulder level. In other words, the full range of motion of the arm is lost. |
Why does this happen? Is this dangerous?
Doctors are still not 100% sure what causes this 'codeine' condition. However, the main theory is that the surgery damages the lymph vessels and small blood vessels in the area. Think about it, our body has a system of small tubes that remove waste fluid (lymph fluid). It is believed that when these tubes are slightly damaged during surgery, they become inflamed, the fluid inside clots, and the channel becomes tight and thickened.
The biggest question you may have is, is this the same as lymphedema , a condition where the arm swells? No, this is not lymphedema. Lymphedema is a condition where fluid builds up in the arm and causes swelling. Cording is a condition where those channels become tight and constricted. Research is still being done to see if there is a connection between these two conditions, but for now, they are considered separate conditions.
Remember, this 'coding' condition is not your fault. And it is a condition that can be successfully managed. The most important thing is to seek medical advice quickly rather than suffering alone.
How is 'codeine' treated?
The good news is that there are effective treatments for this. The first and most important thing to do if you notice these symptoms is to tell your surgeon or your treating physician.
Usually, your doctor will refer you to a physical therapist . Physical therapy is the best solution for this condition. Here's what happens:
- Stretching: Your physical therapist will teach you specific exercises that gently stretch the tight tissues to loosen them.
- Massage: Gently massage the areas where those tight 'cords' are located to loosen the tissue.
- Moist Heat: Moist heat is used to reduce pain and loosen tissues.
- Special treatments: Sometimes, things like low-intensity lasers can help break down this hardened tissue.
- Painkillers: If necessary, the doctor will give you painkillers to control the pain.
One thing to remember during treatment . Sometimes when you loosen a 'cord' in one place, the pain may increase a little further down. That's a good sign! It means the tight tissue is breaking down and the arm is free. So don't worry about it.
What happens after treatment?
Usually, this 'codeine' condition will resolve almost completely within a few sessions of physical therapy, or within a month or two. Very rarely, this condition can recur, but it is very rare. There is no evidence that this has any long-term effects.
The most important thing is to continue doing the exercises prescribed by your physical therapist even after your 'codeine' has healed. These exercises will help you regain full function in your hand after surgery and maintain flexibility in your hand during future treatments.
Take-Home Message
- If you experience a painful, pulling sensation in your arm or armpit after breast cancer surgery, it could be cording . Don't worry.
- This is not dangerous, but it definitely requires treatment because it interferes with hand movement.
- If you have these symptoms, tell your doctor immediately. He or she will refer you to a physical therapist.
- This condition can be almost completely cured with physical therapy (stretching, massage).
- Continuing to do the exercises your doctor gives you after treatment will help you maintain flexibility in your hand.
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