Breast Pain due to Central Sensitization?

[Faith]

Well, about 2.5 months ago it seems out of no where I developed breast pain. It began as quite severe (burning/tenderness/extreme sensitivity to clothing). I had started a low dose of Flexeril at night to help with sleep/muscle pain about 2 months prior so I stopped it in case it was in some mysterious way causing the pain. It did seem to get a little better, but it has continued and varied at different times of my hormonal cycle (sometimes I can't even stand for my daughter to lean up against me!). The biggest symptom that continues throughout the whole month however is pain under my arms (sometimes into the bicep area) and especially around where my shirt sleeves rub in my armpit area.

First of all, WHAT IN THE WOLRD....right?!?! Am, I crazy. I sure feel like it. I finally mentioned it to my pelvic pain doc yesterday. I wondered if perhaps I had developed some fibrocystic breast disease, as this runs in my family, but my pelvic pain doc (a urogyno) felt like my pain was too severe to be something like that. She thought it was likely just central sensitization. Of course she did not examine me as this is not her area of pracitce, but it does seem unlikely to be fibrocystic breast disease due to the extreme sensitivity I am dealing with. But WHY? Why did I all of a sudden devleop more pain in the breast area? Perhaps it's musculoskeltal in cause (as I have biomechanical/alignment issues), but even the symptoms dont' seem to match that.

Any thoughts? Do you agree central sensitization? Should I see my local OBGYN for a 2nd opinoin? Advil/tylenol do help a little I think so I wonder if it really is central sensitization. All I know is...it's about enough to drive me crazy on top of all my other issues!

[helenlegs 11]

Oh Faith!!! feel so bad for you, but that's going to help nothing is it!
If you have a genetic history of this problem you mentioned, get it checked out please. I hope that is easy for you to get organised.
It's another one of those things, a process of elimination.
I hope you get to the bottom of the problem and get it under control at least. Let us know how you get on.
Helen xox

[nyt]

Second opinions are always good esp. considering your family history. Any chance muscle tightness or trigger points are causing some of these problems since Advil/tylenol help this? Have you tried a massage to see if that helps?

[Faith]

Yes, NYT. Massage/warm baths do seem to help a little and I know I have some trigger points in the pectoralis major. Basically I have tons of trigger points all over my body. So many that I can't keep them under control. Likely due to the malaligment issues and core weakness/instability. I am going to probably give it another month before I see my OBGYN about it because even if it is fibrocystic breast disease there's not a lot treatment wise they can do (I've already started taking vit E and primrose oil and have cut out caffeine) and I'd prefer not to go on hormonal birth control pills as they seem to increase my global pain. Thanks for the support ladies as always!

[Violet M]

Hi Faith,

Sorry to hear about this new issue. I have fibrocystic breast disease and it's really more of an ache -- there's no burning or sensitivity and it's not even close to what PNE pain is like. I guess it could be possible you have the disease but because your CNS is already so wound up you are having an abnormal pain response. If it's fibrocystic breasts you should be able to feel lumpy glandular tissue when you do your monthly BSE.

Are you already taking something like lyrica or neurontin for burning pain?

Violet

[Faith]

Hi Violet,

Thanks for responding. Yes, I'm currently on 3000mg of Neurontin and my doc wants me to try to increase it up to 3600mg, but I feel like I've become immune to it. My CNS is definitely in overdrive. I've tried all most all the meds normally used for this. Not sure what to do. I had ESWT in Cornwall 5.5 weeks ago and am still flaring from it (will eventually write a proper report about this). The treatment was extrmely aggressive as we all know and I think too much for my CNS. I think it could be possible I have some underlying fibrocystic breast issues that became worse while on Flexeril (the Flexeril caused increased breast size for me so perhaps increased blood flow and sensitivity with hormonal fluctuations ?) but by the time I stopped the Flexeril (a month after it began) my CNS was in wind-up too much and so the pain stayed to some degree? I've tried doing self breast exams but I can't tell what I feel because I am thin and I can feel my ribs easily so it's all very lumpy feeling to me, really always has been.

I'm learning that CNS sensitization is a big battle. nyt, I know you have a lot of experience with this. Any suggestions? I've looked into ketamine some, but I still feel like I have some underlying biomechanical issues that have yet to be addressed, so I hate to have Ketamine and not fix the problem only for the pain to return. I don't have a good pain management doctor which is another problem. I'm to the point I know I may have to start on narcotics, but I really hate to. I was doing better when I was on the Flexeril too! Resorative sleep is so important for me (and us all!). So cutting that out plus the trauma of the Cornwall protocol has left me "out of control" pain wise

[Violet M]

Wow, Faith. I'm sorry to hear you are really struggling right now even on the high dose of neurontin. It sounds like all of the therapies you are trying that typically are meant to help people are just flaring you up and that must be extremely frustrating. I agree that maybe some stronger meds would be important at this point to help calm things down and help you get some sleep. I know it feels like a step backward but if you can get things calmed down you will be able to think more clearly about what to do next and it will help you through the process until you find what works for you.

Hugs,

Violet

[Poppy]

I have loads of breast cysts too and the pain is not like that but I did go through about 5 years of exactly what you describe. My doctor told me to take evening primrose and it really did work- oh and to try to avoid wearing a bra. He said it wasn't anything like central sensitisation but just something that some women get because of hormonal changes.

[Faith]

Poppy, can I ask what exactly you experienced that I described for 5 years? Also how much evening primrose oil do you take? I have been able to get the breast pain itself to calm down at least for now. This last 3 weeks I've mostly been experiencing irritation to shirt sleeves under my arms. I know the lymph nodes go up into the arms, so perhaps this is what it is? I guess I need to make an appointment with my OB because I'm not sure what exactly I am feeling and my family doc nor my pelvic pain doc would examine me

[Faith]

I wanted to update that for the last week I've been taking ibuprofen 600mg three times a day and my breast pain (which is really more under arm/bicep area pain with hypersensitivity to shirt sleeves) has been a little better. I do know I have trigger points in various muscles throughout my entire body (including chest, back, arms, etc). But in my past experience ibuprofen hasn't helped pain from trigger points much. I have also been on vit E 800mg and evening primrose oil 2600mg for 2 months now and over the last 5 weeks have uped my Neurontin dosage to 3000mg daily. So not sure what exactly is helping, but seems like the ibuprofen has made a big difference. Am hoping to see a body worker skilled in trigger points sometime in the next month and hoping they can help me identify if the pain is coming from trigger points. My massage therapist thinks it is more muscular realted as I have extremely tight muscles in my chest/upper arms. I am grateful the burning pain in my breasts has been gone now for several weeks.