Shoulder pain after breast cancer is unfortunately common. Surgery and treatment can leave you with chronic pain, stiffness, and limited mobility that affects your daily life. For some people, shoulder discomfort also becomes a constant reminder of their diagnosis, which is tough emotionally.

As a physical therapist and Board-Certified Oncology Specialist, I see shoulder pain often in my practice. Even though it affects many breast cancer survivors, medical teams don’t always address them. Some of my patients have dealt with shoulder pain for years after treatment ended.

But just because shoulder pain is common doesn’t mean it’s normal or something you have to accept.

Physical therapy can help you reduce pain, improve shoulder and arm mobility, and prevent complications like lymphedema. In this article, I’ll share 7 exercises to get you started, and you can find more tools in my physical therapy program, Healthy Shoulder.

What Is Shoulder Pain After Breast Cancer Treatment?

Shoulder pain after breast cancer treatment can show up in a few different ways:

• Chronic pain, discomfort, or stiffness in the shoulder
• Limited range of motion that makes it hard to lift your arm or reach overhead
• Muscle weakness, especially if you had lymph nodes removed during surgery
• Difficulty with daily activities like getting dressed, bathing, or reaching into cupboards

The physical symptoms are only part of it. Chronic shoulder pain can also affect you emotionally. Many of my patients feel frustrated and overwhelmed when they can’t find reliable information about how to manage their discomfort, especially with persistent or severe pain.

Shoulder Pain After Breast Cancer Surgery

Breast cancer surgery causes direct trauma to the chest, shoulder, and underarm area.

Whether you had a mastectomy or breast-conserving surgery, the procedure affects muscles, nerves, and connective tissue around your shoulder.

Some people develop Post-Mastectomy Pain Syndrome, which includes chronic pain in the chest wall, armpit, shoulder, and arm that lasts for months or years after surgery. Lymph node removal during surgery can also damage nerves and change how your shoulder moves and functions.

Learn more about exercise after a mastectomy and how it can help.

Shoulder Pain After Radiation for Breast Cancer

Radiation therapy targets cancer cells, but it also affects healthy tissue in the treatment area.

The radiation causes inflammation and fibrosis (tissue scarring and thickening) in the muscles, connective tissue, and skin around your chest and shoulder. This often leads to stiffness, reduced flexibility, and pain that can develop during treatment or months after.

What Causes Shoulder Pain After Breast Cancer?

Shoulder pain after breast cancer treatment develops because of a few different reasons, and most people experience more than one of these causes at the same time:

• Lymph node removal: When surgeons remove lymph nodes, they disrupt tissue and nerves in the area, which leads to shoulder pain, weakness, and trouble moving your arm
• Radiation therapy: Radiation causes tissue changes that create stiffness, swelling, and pain in your shoulder that can get worse over time
• Surgical scars: Scars from mastectomy and other procedures limit how much you can move and cause pain
• Nerve damage: Surgery can damage nerves, which causes nerve pain, tingling, numbness, or weakness in your shoulder and arm
• Muscle and tissue trauma: Breast cancer surgery disrupts your normal tissue, leaving your muscles sore, weak, and tight
• Limited movement after surgery: When you can’t move your shoulder normally while you’re healing, it gets stiff and can turn into frozen shoulder

When you have severe pain, you might also avoid using your shoulder. This can sometimes create a cycle where less movement leads to more stiffness and pain.

Try these stretches after breast cancer to reduce pain intensity and improve shoulder problems.

Arm Pain After Breast Cancer

Shoulder pain often comes with arm pain. The causes are similar, such as nerve damage, lymph node removal, radiation, and scar tissue.

Sometimes people also develop neck pain because their body compensates for shoulder and arm problems.

Just like with shoulder pain, you can treat arm pain after breast cancer with physical therapy.

Arm swelling is another, separate issue to watch for. Breast cancer treatment can damage your lymphatic system, which increases your risk of developing breast cancer-related lymphedema.

This happens when lymph fluid builds up in your arm because the lymph nodes that normally drain fluid from your arm and breast tissue were removed or damaged during treatment.

You can learn more in my program, Breast Cancer Rehab.

Shoulder Pain After Breast Cancer Is Common, Not Normal

There are more than 4 million breast cancer survivors in the US, and many of them deal with long-term side effects after treatment ends, both physical and mental.

Shoulder pain is one of them. In fact, in my physical therapy practice, patients often come to me months or years after finishing treatment, still struggling with shoulder pain.

But the fact that shoulder pain after breast cancer is common does not mean that you have to accept it.

A physical therapy exercise program can help you reduce pain, improve your range of motion, and get back to the activities you love.

How Do You Treat Shoulder Pain After Breast Cancer?

Physical therapy is the main treatment for shoulder pain after breast cancer.

A physical therapist will look at your shoulder mobility, strength, and pain, and create an exercise program to address these concerns. Treatment typically includes:

• Stretching tight muscles
• Strengthening weak areas
• Improving your posture
• Gradually increasing your range of motion

Unfortunately, for many people, seeing a physical therapist in person isn’t realistic because of cost, time, or location.

That’s why I created the Healthy Shoulder Program. It’s an online physical therapy resource that gives you the same techniques, tools, and exercises I use with my patients in the clinic!

7 Exercises to Improve Pain in Shoulder After Breast Cancer

Below are 7 exercises that help with shoulder and arm problems after breast cancer. You can also follow along with this YouTube video:

1. Pec Muscle Stretch

Your pec muscles are the large muscles across your chest. Breast cancer surgery often irritates and inflames these muscles, so gently stretching them can reduce discomfort.

How to do it:

1. Lie on your back and place your hands behind your head with your elbows pointing toward the ceiling.
2. Let your elbows slowly fall out to the sides until you feel a mild stretch across your chest.
3. Pause and take a deep breath. Relax into the stretch.
4. Hold for 5 seconds, then slowly bring your elbows back to the ceiling.
5. Repeat a few times, gradually increasing the stretch.

Goal: Work up to 10-second holds and repeat 3-5 times. Do this once or twice a day.

2. Pec Stretch on Your Side

How to do it:

1. Lie on your side and place your top hand behind your head with your elbow pointing forward.
2. Slowly rotate your top elbow open, trying to point it toward the wall behind you.
3. Stop when you feel a mild stretch across your chest.
4. Take a deep breath and relax into the stretch.
5. Hold for a few seconds, then return to the starting position.

Goal: Work up to 10-second holds and repeat 3-5 times. Do this once or twice a day.

3. Lat Muscles Stretch

Your lat muscles are large, flat muscles on each side of your upper back. Breast cancer surgery can affect these muscles and make it hard to raise your arm above your head. This limits everyday activities like bathing or reaching into cupboards.

How to do it:

1. Kneel on the floor and sit back into your heels.
2. Walk your hands forward and sink your chest toward the floor.
3. Stop when you feel a mild stretch in your back and underarms.
4. Take a deep breath and relax.
5. Hold for 10 seconds.

Goal: Repeat 3-5 times, once or twice a day.

If kneeling is uncomfortable: Sit in a chair at a table and reach forward across the table until you feel a mild stretch.

4. Scapular Squeezes

This is one of the best exercises for building shoulder strength after breast cancer! Scapular squeezes strengthen your shoulder blades and improve your posture.

How to do it:

1. Sit or stand with good posture.
2. Pinch your shoulder blades together, down and back.
3. Think about squeezing your shoulder blades down into your back pockets and opening your chest.
4. Hold briefly, then release.

Goal: Do 10-15 repetitions for 2-3 sets, once or twice a day.

5. Scapular Wall Slide

How to do it:

1. Stand at a wall with your elbows and forearms touching the wall, parallel to each other.
2. Press your elbows against the wall and back up until your arms feel fully extended, like you’re punching away from your body.
3. Slide your arms up the wall, keeping them as close to the wall as you can (your elbows will come off the wall a little).
4. Slide your arms back down.

Goal: Repeat 10-15 times for 2-3 sets, once or twice a day.

6. Ceiling Punches

This exercise works your serratus anterior muscle, which controls and stabilizes your shoulder blade.

How to do it:

1. Lie on your back and raise your arm straight up toward the ceiling (90 degrees).
2. Keep your elbow straight and punch your hand up toward the ceiling.
3. Relax your shoulder blade back down.

Goal: Repeat 10-15 times for 2-3 sets, once or twice a day.

To add resistance: Hold a light dumbbell.

7. Sidelying Rotator Cuff Strengthening

How to do it:

1. Lie on your side and place a rolled towel under your elbow.
2. Bend your elbow to 90 degrees with your hand near your belly.
3. Rotate your arm open, moving your hand up toward the ceiling.
4. Keep your elbow at your side, touching the towel. Don’t rotate your body.
5. Lower your hand back down.

Goal: Repeat 10-25 times for 2-3 sets, once or twice a day.

Is Shoulder Pain a Sign of Breast Cancer Returning?

No, shoulder pain is not a sign that breast cancer is coming back. But I understand why it can feel like a constant reminder of your diagnosis, which can be difficult emotionally.

Breast cancer is highly treatable, but it’s important to stay aware of the signs of recurrence. However, shoulder pain isn’t one of them. That said, chronic shoulder pain can be very uncomfortable and make your quality of life worse, which is why treating it matters.

FAQs

Can breast cancer spread to your shoulder?

Breast cancer can spread to bones, including the bones in your shoulder, but this is different from the shoulder pain you may experience after the treatment. Shoulder pain from cancer spreading to the bone would show up on imaging tests and comes with other symptoms. The shoulder pain I’m talking about in this article comes from treatment side effects, not from cancer in the shoulder.

Why does my upper back hurt after breast cancer?

Upper back pain after breast cancer happens for similar reasons as shoulder pain. Surgery and radiation affect the muscles, nerves, and tissue in your chest, shoulder, and upper back. When your chest muscles get tight from surgery or scar tissue, your upper back muscles have to work harder to compensate. Poor posture from guarding your surgical side can also strain your upper back.

What does breast cancer shoulder pain feel like?

For some people, it can feel like a deep ache or stiffness. It can also present as sharp or shooting nerve pain, especially if nerves were damaged during surgery. Often, you might feel tightness across your chest that pulls on your shoulder, or have trouble lifting your arm without pain. The pain can be constant or come and go, and it often gets worse when you try to reach overhead or behind your back.

Why does my arm and shoulder hurt after breast cancer? 

Your arm and shoulder may hurt after breast cancer treatment because of nerve damage, lymph node removal, scar tissue, radiation changes, and limited movement during recovery. The nerves and lymphatic vessels that run through your armpit connect your arm and shoulder, so damage in that area affects both. Weakness in your shoulder also makes your arm feel heavier and harder to use.

Physical Therapy for Shoulder Pain After Breast Cancer

Shoulder pain and discomfort after breast cancer surgery or radiation is common, but you don’t have to accept it as your new normal.

Building a consistent exercise routine can help you reduce pain, improve strength, and get back to the activities you enjoy. As a Board-Certified Oncology Specialist and physical therapist, I’ve seen how much difference PT exercises can make for my patients.

If you’re looking for a resource to get started, learn more about my Healthy Shoulder Program.