Osteopathic Manipulative Treatment as an Adjunctive Therapy for Post-mastectomy Pain Syndrome: A Case Report

Post-mastectomy pain syndrome (PMPS) is a common yet often under-treated complication of breast cancer therapy, affecting an estimated 20-60% of patients. Characterized by persistent pain lasting greater than three months following breast surgery, PMPS is multifactorial in etiology, involving neuropathic injury, post-surgical fibrosis, radiation-induced tissue changes, and musculoskeletal dysfunction. Current management strategies emphasize a multidisciplinary approach, including pharmacological therapies and non-pharmacological modalities. Despite this, treatment outcomes remain variable, and many patients continue to experience refractory symptoms. Osteopathic manipulative treatment (OMT), a hands-on approach targeting somatic dysfunction and improving lymphatic and musculoskeletal function, represents a potentially valuable yet underexplored adjunct in this population. We present the case of a 72-year-old female with stage IIIA triple-negative breast cancer who developed refractory PMPS following mastectomy, axillary dissection, and radiation. After limited improvement with massage therapy, she underwent OMT incorporating myofascial release, muscle energy, and balanced ligamentous tension. She reported improvement in pain and functional mobility, with decreased reliance on adjunctive therapies. This case highlights OMT as a promising adjunct for PMPS warranting further investigation.