Axillary Web Syndrome (Cording)
Dear OncoLink "Ask The Experts,"
I had a lymph node dissection and have developed lymphedema (mild), but have a painful condition which my physical therapist says is called roping or cording. The nerves were injured during surgery. I cannot find relief and no one seems to know what to do. In the meantime, I have to have radiation therapy and cannot get my arm up [for the radiation treatments] because of this condition. Do you know anything about it?
Linda McGrath Boyle PT, DPT CLT-LANA, Cancer Rehab Specialist and OncoLink Lymphedema Team Editor, responds:
This is also known as Axillary Web Syndrome, and is most likely the result of a lymphovenous injury. This condition appears most often within the first week to 10 days after surgery. It is characterized by the development of palpable cords of subcutaneous tissue that extend from the axilla (armpit) into the inner arm. These cords can result in pain and a limitation of shoulder abduction. Our team works with patients with this condition, up to 3 times per week in some cases, in order to gently stretch the subcutaneous cords. This allows the patient to lift the arm and be able to receive radiation therapy. AWS is self-limiting and often resolves spontaneously. It is very important that the patient perform a prescribed home stretching exercise program several times throughout the day.