Chronic Back Pain After Latissimust Flap Breast Reconstruction

10 Jun

Last night I turned over in bed and all of a sudden I had a merry Explosion of pain in my back. It still aches pretty badly this morning. Over this past 14 months I’ve noticed intermittent back pain that I had been chalking up to back weakness.

But according to THIS research paper abstract, 10% of their test group had chronic back pain as a complication after a latissimus flap breast reconstruction.

Chronic pain is defined as being long lasting but intermittent. According to this informed consent form, chronic back pain may occur when nerves become trapped in the ensuing scar tissue.

I have been told by massage therapists that cross fiber friction massage can break up scar tissue. However, Dr. Elliott’s office told me that it really doesn’t make a difference and what helps the most is exercise. So we have differing opinions in evidence. So here, I have to ask myself, which one is helping me and which is helping himself?

The massage therapist receives a fee for each massage and it takes multiple massages to “break up the adhesions”. Yes, they call the scar tissue adhesions even though the ONLY place there can BE adhesions is when the abdominal wall grows onto the lower intestinal tract (or adheres) after abdominal surgery. The doctor’s office has nothing to gain by promoting excercise.

Add to that, there are not studies that I have found that advocate for cross fiber friction massage as a treatment for this particular type of chronic back pain. If there are, I would love to read them and would happily change my assertions.


Posted by on June 10, 2010 in Uncategorized


8 responses to “Chronic Back Pain After Latissimust Flap Breast Reconstruction

  1. Browncoat Marc

    June 10, 2010 at 8:23 am

    I say go with the exercise. I have noticed that after my surgeries I have had some nerve issues and the more I have exercised the more they have gone away. I was at the doc yesterday and she said I was looking really good and was very pleased with how I was doing. I run a good bit and have now started the one hundred push ups challenge. If you looked at me you would never know that this time last year I was laying in a hospital bed, I had a heart attack and had cancer and had my left kidney removed. I will say getting out and being active is a big help in this I am sure.

    I know I still need to write something on my nerve damage for you. Would you like photos as well?

  2. Keetara

    June 10, 2010 at 8:29 am

    Well, I’ll give you my experience with trapped nerves in scar tissue. After my first round of reconstructive surgery, which consisted of a lower body lift with abdominoplasty, I had a place on the left side of my groin (about even with the top of the pubic triangle) that hurt like the very dickens if I moved wrong. I spoke with my plastic surgeon about it and both he and I were convinced that it wasn’t that the skin had been pulled too tight, but that nerves had gotten caught in the scaring. We kind of figured that there wasn’t much I could do about it and to just ignore it the best I could. I got back into my exercise program which consisted of cardio and weight lifting workouts with a lot of stretching. I have always included stretching for about a 1/2 hour because I like to maintain my flexibility. Well, none of that helped with the sudden, catching, zinging pain that would hit when I moved my leg and my torso in the wrong way.

    About 2 years after that surgery I met a woman who does many different types of massage and I set up some sessions with her to work on some back and hip pain I was having. During one of those sessions I moved the wrong way and she noticed the pain. So she had me flip over onto my back and did some work on my left groin. I even remember feeling a bit of snap (not painful) during the massage when the “adhesion” broke loose. Since that one, single massage, I’ve not had ANY of that pain.

    I’m not saying that it ~will~ work for you, but it’s worth the try for a few sessions. I would also do the exercises, weight lifting and stretching, that will help strengthen the muscles remaining in your back.

    Good luck!

    • Kathy K

      January 21, 2011 at 2:57 pm

      What type of a massage therapist is this? How can I find one like this?

      • Keetara

        January 23, 2011 at 1:09 pm


        The massage therapist that I saw had training in what I guess is basic, standard massage therapy, some myofascial techniques, and Watsu, which is a warm water submersion body massage that involves a fair amount of stretching. But most massage therapists should have some training in working with scars.

        If you live in the Washington, DC area, I can give you the contact info for the woman I saw.

  3. Shippoly

    July 12, 2010 at 5:29 pm

    I had a lattisimus flap done in August `09 and got my implants on December 31st of `09. Though I have had some complications with the nipple construction (necrosis and flattening), I will say I am happy to have my girls back (and bigger than they were before). I have alot of scarring, partially from radiation, the rest from surgeries including a skin graft. I have always had really soft, sensitive skin which is great for others to touch but has worked against me in with the reconstruction.

    I have had 2 bouts of really debilitating lower back pain. I actually had to miss a couple of days of work and call my doctor this last time. I was applying heat and laying on the floor with my legs on the coffee table, but by the afternoon I could barely walk. Sitting, driving, leaning forward and bending were all creating a shooting pain that actually made me cry out a couple of time. It wasn’t until about 3 days later and the pain began to subside that I began to realize that the cause could quite possibly be my latissimus flap and other back muscles compensating for the lack of an LD on my right side. I have been exercising more (I too am trying lose weight, have 12 more pounds to go for a total of 35!!). Though it may be a combination of exercise and lifting incorrectly, it seems like this time the pain started after I was moving my Kitchen Aid mixer. I realize those things are heavy, but really???

    I am relieved to find other people experiencing lower back pain after this surgery. Its always good to know you are neither a wimp or crazy! I am going to ease back into exercising. I have been off for a week now and its making me crazy. I will also try the massage as soon as I can afford it.

    • Carolyn

      May 20, 2011 at 11:55 am

      Your insurance may pay for therapy after you surgeries, My insurnace completely paid for all massage and miofacial therapys, If you are sitll expereincing difficulties try your insurance carrier and the Cancer Center of American are up to date with the latest in myoficial techniques. It a miracle with what the did to release my pain

      • Maria_Myrback

        May 20, 2011 at 12:19 pm

        At the time, I didn’t have insurance. Everything was self-pay. For other readers, this is a helpful tip.

  4. Jamie Montelongo

    February 11, 2012 at 12:06 am

    Exercise is great, we should all do it to the extent that is correct and balanced for each person’s circumstance. But please don’t disregard the wonderful results possible with therapeutic massage. It is true that there are not a lot of studies out there that offer clinical proof of the benefits, but there are many personal accounts of pain relief that should not be discounted. Massage therapy supports physical, mental and emotional well being. Look for a massage therapist with some training and knowledge about oncology massage. There are adjustments that need to be made for clients with cancer or histories of cancer.

    I have been working with oncology clients for 10 years, and I would love to do a study about back pain and latissimus flap reconstruction and massage for pain relief. I work in the San Antonio, TX area. I have my own office, and also work at SLEW Wellness Center for women with cancer / cancer histories.


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