Pain Syndromes

Post-radical neck dissection syndrome is defined as neck and/or shoulder pain starting within 2 months after radical neck dissection. Patients complain of sharp or shooting pains in the ear, neck, and shoulder. The prevalence of this syndrome is unknown. In one survey of 25 patients with this diagnosis, all had neuropathic pains in the distribution of the superficial cervical plexus and 72% experienced regional myofascial pain.94 There are no specific recommendations. Carbamazepine has been recommended because ofits effectiveness in a related condition, trigeminal neuralgia. A pilot trial of botulinum toxin A in 16 patients decreased pain severity.95

Head and neck cancer survivors are at increased risk for myofascial pain syndromes, which may respond to relaxants such as cyclobenzaprine.

7.2. Breast Cancer

Breast cancer survivors may experience breast pain, arm pain, and dyspareunia. The breast pain often results from surgery, the arm pain is secondary to lymphedema, and dyspareunia is considered a menopausal symptom related to hormonal therapy.

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