Recovery is something that you have to work on every single day, and it’s something that it doesn’t get a day off. It takes a lot of strength to ride the cancer recovery journey, but it is worth the fight.
Musculoskeletal disorders are one of the long-term side effects of breast cancer treatment. This apart from nerve disorders, and oedema (swelling) disorders. As we speak, I am dealing with nerve disorders and musculoskeletal disorders.
Nerve disorders in my case is peripheral neuropathy, which began after chemotherapy. This caused damage to the nerves located outside of the brain and spinal cord or peripheral nerves, often causes weakness, numbness and pain, usually in the hands and feet. It also affects other areas and body functions including digestion, urination and circulation.
Peripheral neuropathy may lessen or go away over time, but in some cases, they never go away. So, I will just need to learn to live with neuropathy pain, which is like walking on a bed of nails or shards of broken glass, at times.
In the meantime, I take Vitamin B Complex supplements, do regular exercise, such as walking three times a week. This helps me reduce neuropathy pain, improve muscle strength and help control blood sugar levels. Next, I will contemplate gentle routines such as yoga, tai chi or qigong.
Musculoskeletal disorders include any pain or dysfunction related to muscles, joints or skeletal system. Broadly speaking, breast cancer treatment causes musculoskeletal disorders by damaging normal cells and tissues which in turn can disrupt the complex interplay between muscles, tendons, nerves, fascia or connective tissue, and joints.
In my case, it resulted in acute or chronic pain, weakness, reduced range of motion, and altered movement patterns.
My musculoskeletal disorders predicament began after radiotherapy. Radiation causes tissue changes within the chest or breast, armpit, neck, and back areas, depending on the treatment area. These tissue changes not only burn my skin, but also tightened my muscles and tissues underneath.
These changes created further restrictive forces on my shoulder joint’s normal movement pattern and range, causing further irritation and inflammation of my rotator cuff tendons. This caused weakness of the muscles of my rotator cuff, shoulder blade, or other stabilising muscles. And this in turn decreased the dynamic stability of my shoulder joint.
I have been seeing an Orthopaedic Surgeon at KPJ Ampang Puteri, Dr. Kamalnizzat Ibrahim to fix my musculoskeletal disorders. I underwent a procedure called Manipulation Under Anaesthesia (MUA) in December 2021.
MUA consists of a series of mobilization, stretching, and traction procedures performed while the patient receives anaesthesia (usually general anaesthesia or moderate sedation). Manipulation is intended to break up fibrous and scar tissue to relieve pain and improve range of motion.
Post-surgery, I underwent rigorous physiotherapy for three months. My therapy at the hospital included transcutaneous electrical nerve stimulation where electrodes were placed on my neck and shoulder to deliver a gentle electric current at varying frequencies.
After physiotherapy, my Orthopaedic Surgeon prescribed trigger points injections of steroids to relieve pain. However, steroids triggered irritable bowel syndrome and gastritis in me. It was so bad I was nauseating and vomiting. So, we changed treatment.
As trigger points injections of steroids did not work for me, my Orthopaedic Surgeon prescribed a simple minor procedure under local anaesthetic on my neck and shoulder called Dry Needling Therapy. During the procedure, the thin monofilament needle penetrates the skin and treats underlying muscular trigger points for the management of neuromusculoskeletal pain and movement impairments.
This would relieve the tight muscle and dull aching pain that I have been lingering on my neck and shoulder. It’s been robbing me of good sleep and flexibility of movements.
I was extremely exhausted after Dry Needling Therapy – it was a painful procedure. I had to take a much-needed day off to rest and recuperate on Tuesday. I couldn’t lift up my shoulder for the rest of the day, but it would be temporary, a day or two. My neck and shoulder would be sore for 24 to 48 hours following treatment. But it may resolve on its own or with gentle activity or stretching of the area or light massage.
Dry Needling Therapy works better for me than the trigger points injections of steroids. Even though it is a painful procedure, it did not trigger irritable bowel syndrome and gastritis, and therefore no nausea and vomiting.
My cool Harley Davidson biker Orthopaedic Surgeon said, after several sessions of Dry Needling Therapy, my musculoskeletal disorders should heal. In shaa Allah.
The road to recovery will not always be easy, but I will take it one day at a time. It does not matter how slowly we go, as long as we do not stop. On the brighter side of things, the fact that we woke up this morning is proof that this day has already been predetermined in our favour. Because, it is an opportunity to embrace a new day and do new things.