Web Axillary Pain Syndrome—Literature Evidence and Novel Rehabilitative Suggestions: A Narrative Review

Francesco Agostini, Carmine Attanasi, Andrea Bernetti, Massimiliano Mangone, Marco Paoloni, Edoardo del Monte, Massimo Mammucari, Enrica Maggiori, Domenico Russo, Raffaele Di Marzo, Alberto Migliore and Teresa Paolucci
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Francesco Agostini: Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
Carmine Attanasi: Physical Medicine and Rehabilitation Unit, Santa Caterina Novella Hospital, 73013 Lecce, Italy
Andrea Bernetti: Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
Massimiliano Mangone: Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
Marco Paoloni: Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
Edoardo del Monte: San Camillo Forlanini School of Physiotherapy, 00152 Rome, Italy
Massimo Mammucari: Primary Care Unit ASL RM 1, 00193 Rome, Italy
Enrica Maggiori: Primary Care Unit ASL RM 1, 00193 Rome, Italy
Domenico Russo: San Marco Hospice and Palliative Care, 04100 Latina, Italy
Raffaele Di Marzo: Italian Society of Mesotherapy, 00185 Rome, Italy
Alberto Migliore: Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, 00186 Rome, Italy
Teresa Paolucci: Department of Oral Medical Science and Biotechnology, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy

IJERPH, 2021, vol. 18, issue 19, 1-9

Abstract: Axillary web syndrome (AWS) is defined as a visible and palpable network of cords in the skin of the axillary cavity that are tensed by shoulder abduction following surgery for breast cancer, causing significant functional limits of the ipsilateral upper limb (UL) and pain. The purpose of this narrative review is to discuss rehabilitation approaches for greater efficacy with respect to pain and novel suggestions. AWS is a frequent complication of axillary lymphadenectomy that necessitates a thorough follow-up in the medium to long term. Physiotherapy is effective in the treatment of functional limb deficits, the management of pain, and the treatment of upper limb disability. The best management approach involves the use of soft tissue techniques to slow the natural course of the syndrome, in association with therapeutic exercises for functional recovery and muscle strengthening. AWS is linked secondary lymphedema, requiring integration with manual lymphatic drainage. The physiotherapy management of AWS is currently fragmented, and insufficient information is available on the nature of the disease. Thus, randomized and controlled studies that compare rehabilitation approaches in AWS are desirable, including the possibility of using mesotherapy in the treatment of axillary and upper limb pain.

Keywords: physiotherapy; axillary web syndrome; rehabilitation; breast cancer; lymphadenectomy; mesotherapy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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