Involuntary Muscle Twitches After Breast Surgery: Causes and Solutions

Involuntary twitching

My mother experiences involuntary twitching in her right armpit and upper back after undergoing a mastectomy on her right breast.
During severe episodes, she also experiences pain.
Pain relief injections and anti-inflammatory medications have not been effective.
She has consulted many doctors, including specialists in rehabilitation, neurology, and surgery, but they are unable to determine the cause.
She has also seen a psychiatrist, considering the possibility of psychological factors, but that has not resolved the issue either.
The rehabilitation doctor suggested it might be a rare disease, but he could not specify what it is.
This involuntary twitching is causing her significant discomfort.
Is there any way a doctor can help my mother?

Nina, 20~29 year old female. Ask Date: 2012/06/07

Dr. Lan Shengxing reply Neurology

Dear Nina, there are many causes of involuntary movements, and unfortunately, not all of them can be fully diagnosed.
Sometimes, it requires a trial-and-error approach with medication.
I recommend that you first consult a neurologist.
Possible directions to explore include brain disorders, spinal cord diseases, and some medications that can help suppress involuntary movements, such as Baclofen.

Reply Date: 2012/06/07

More Info

Involuntary muscle twitches, also known as fasciculations, can occur after breast surgery for various reasons. Your mother's experience of involuntary muscle twitching in the armpit and upper back area following her right breast removal is understandably distressing, especially when accompanied by pain. While it can be frustrating that multiple specialists have not provided a definitive diagnosis, it is essential to consider several potential causes and management strategies.

Possible Causes
1. Nerve Damage or Irritation: During breast surgery, nerves in the surrounding area may be affected. This can lead to abnormal nerve signaling, resulting in involuntary muscle contractions. The brachial plexus, a network of nerves that innervates the arm and shoulder, could be impacted during surgery, leading to twitching or spasms.

2. Muscle Strain or Imbalance: After surgery, the body undergoes significant changes, including alterations in muscle use and posture. If certain muscles are overcompensating for those that have been affected by surgery, this can lead to muscle fatigue and spasms.

3. Scar Tissue Formation: Post-surgical scar tissue can develop around nerves and muscles, potentially leading to irritation and involuntary movements. This can also contribute to discomfort and pain in the affected areas.

4. Psychological Factors: Stress and anxiety related to the surgery and recovery process can manifest physically. While it’s essential to rule out physical causes, psychological factors can exacerbate muscle tension and discomfort.

5. Electrolyte Imbalance: Sometimes, an imbalance in electrolytes (such as calcium, potassium, or magnesium) can lead to muscle twitching. This is often overlooked but can be easily checked through blood tests.

6. Medication Side Effects: If your mother is taking medications for pain or inflammation, some of these can have side effects that include muscle twitching. It’s worth reviewing her medications with her healthcare provider.

Management Strategies
1. Physical Therapy: Engaging in physical therapy can help address muscle imbalances and improve strength and flexibility. A physical therapist can provide targeted exercises to alleviate discomfort and reduce involuntary movements.

2. Pain Management: If over-the-counter pain relievers and anti-inflammatory medications are ineffective, discussing alternative pain management strategies with a pain specialist may be beneficial. This could include nerve blocks or other interventions.

3. Stress Reduction Techniques: Incorporating stress management techniques such as mindfulness, meditation, or gentle yoga can help reduce muscle tension and improve overall well-being.

4. Nutritional Support: Ensuring a balanced diet rich in essential vitamins and minerals can help prevent electrolyte imbalances. If necessary, a consultation with a nutritionist may provide additional insights.

5. Neurological Evaluation: If the twitching persists and remains unexplained, a thorough neurological evaluation may be warranted. This could include imaging studies or nerve conduction studies to assess for any underlying neurological issues.

6. Follow-Up with Specialists: Continuing to follow up with specialists, including neurologists and pain management experts, is crucial. Sometimes, a fresh perspective or additional tests can lead to new insights.

7. Support Groups: Connecting with support groups for breast cancer survivors may provide emotional support and shared experiences that can be beneficial for both your mother and your family.

Conclusion
Involuntary muscle twitching after breast surgery can be multifactorial, and while it may take time to identify the exact cause, a comprehensive approach that includes physical therapy, stress management, and nutritional support can be beneficial. Encourage your mother to maintain open communication with her healthcare providers and advocate for her needs. It’s essential to remain persistent in seeking answers and exploring various treatment options to improve her quality of life.

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